Optic Neuropathies(1) Dr. Jakirlic

Question 1

What was the 3 different treatments used in the Optic Neuritis Treatment Trial(ONTT)?

Answer 1

IV methylpredinisolone 250mg QID x 3 days, followed by oral prednisone 1mg/kg/day x 11 days
Oral prednisone 1mg/kg/day x 14 days
Oral placebo x 14 days

Question 2

What is the purpose of the ONTT?

Answer 2

better understanding of relationship between ON and MS

Question 3

IV steroids _____ risk for development of MS after initial attack of ON for 2 years.

Answer 3

reduced

Question 4

Will the IV steroids beneficial in reducing the risk for developing MS after 2 years of ON?

Answer 4

No

Question 5

In Longitudinal Optic Neuritis Study (LONS), What is the overall % risk of developing MS in 15 years after ON?

Answer 5

50% with 75% female and 34% male

Question 6

Initial ____ is most predictive risk factor or MS?

If you see 0 lesion is ___%, 1 lesion is ____% and 3+ lesions is ____ % of developing MS in the future.

Answer 6

MRI

25, 60, 78

Question 7

According to LONS, what are the risk factors for MS?

Answer 7

white, family history of MS, ill-defined Neurologic complaints and previous episode of acute ON.

Question 8

According to LONS, what are the lower risk factors for MS?

Answer 8

severe disc swelling, no pain, disc or peripapillary hemorrhage, retinal exudates, NLP vision and male sex.

Question 9

In the CHAMPS, Avonex reduced the risk for MS by how many percent?

Answer 9

44%

Question 10

The chance of developing MS when pt is on Avonex is ___% and placebo is ___%.

Answer 10

35, 50

Question 11

Which MS medication can cause CME?

Answer 11

Gilenya (oral medication). requires OCT before treatment and 4 months after.

Question 12

What is the Oligoclonal Bands Blood Test indicate?

Answer 12

this is to test the CSF. the band indicates inflammation of the CNS

Question 13

If you see hemorrhage and severe optic nerve swelling, which type of ON is that?

Answer 13

Atypical

Question 14

Is typical ON unilateral or bilateral?

Answer 14

Unilateral

Question 15

is Atypical ON unilateral or bilateral?

Answer 15

bilateral

Question 16

Blood work is required for which type of ON? typical or atypical?

Answer 16

atypical, it’s an inflammatory response.

Question 17

What are the causes to atypical ON?

Answer 17

connective tissue disease: Lupus, Sjogren’s and Bechet’s
Infectious: viral or bacterial (Lyme, syphilis)
infiltrative: sarcoidosis or cancer (lymphoma, leukemia)

Question 18

What is another name for neuromyelitis opitca (NMO)?

Answer 18

Devic’s syndrome

Question 19

is NMO unilateral or bilateral?

Answer 19

usually bilateral

Question 20

What is neuromyelitis?

Answer 20

inflammation of the spinal cord and optic nerves

Question 21

What is the average age of onset for NMO?

Answer 21

39

Question 22

Is the prognosis for NMO better or worse than ON or MS?

Answer 22

worse

Question 23

which of these can cause respiratory failure? MS or NMO?

Answer 23

NMO

Question 24

is there a CSF oligoclonal bands present in NMO pt?

Answer 24

No