Optic neuritis, primary demyelination of the optic nerve, is the best-studied optic nerve disorder due to the efforts of the Optic Neuritis Treatment Trial (ONTT). The ONTT prospectively followed a cohort of 448 patients presenting to a variety of medical centers with optic neuritis and visual loss. Patients were divided into three groups: no treatment (placebo), oral prednisone 80 mg/ day and 3 days of intravenous methylprednisolone 250 mg four times daily followed by 11 days of prednisone 80 mg/day.1-4

The prospective data obtained in this study can be applied to a larger cohort of patients. Seventy-seven percent of the patients were female, the average age was 32 years and 85% of the patients were white. Optic neuritis is a disease primarily of white females of northern European ancestry. It is uncommon in those of southern European, African and Asian descent. In these patients, be attuned to the differential diagnosis for atypical optic neuritis (see below).