Optic neuritis is an inflammatory condition of the optic nerve characterized by a sudden onset of visual loss. At present, management of optic neuritis in Vietnam is still controversial about steroid use. Here, in the Friendship hospital "pulse steroid" was applied to treat 25 patients (36 eyes) with optic neuritis. Bilateral optic neuritis was seen in 11 patients (44 percent). Retrobulbar optic neuritis was in 16 eyes (44.44 percent), papilitis in 9 eyes (25 percent), neuro-retinitis in 11 eyes (30.56 percent). Patient's age was 30 years in 52 percent; 60 years in 17 percent. Before treatment, visual acuity (VA) was 1/10 in 21 eyes (58.33 percent) (of these 2 eyes had no light perception, 1 had light perception, 2 had just hand movement); VA 1/103/10 in 15 eyes (41.67 percent). General conditions were blood hypertension (1 patient); diabetes mellitus (1 patient), recovered Dengue fever (4 patients). The dose of intravenous methylprednisolone was 1000mg per day in 3 days (7 patients); 500 mg per day in 3 days (15 patients); 500mg per day in 5 days in (3 patients). VA after "pulse steroid": 4 eyes (11,11 percent) had hand movement; 2 eyes (5,56 percent) VA of counting fingers 1/10; 8 eyes (22,22 percent) VA 1/10'3/10; 13 eyes (36,11 percent) VA 3/105/10; 8 eyes (22,22 percent) VA 5/108/10; 1 eyes (2,78 percent) VA ~8/10. VA at 1 month follow-up (22 patients, 32 eyes): 1 eyes (3,12 percent) VA 1/103/10; 1 eyes (3,12 percent) VA 3/105/10; 7 eyes (21,88 percent) VA 5/108/10; 23 eyes (71,88 percent) VA or = 8/10. No complication was seen during and after "pulse steroid". No recurrent case was seen during 6 months followup. "Pulse steroid" was safe and effective for optic neuritis treatment, therefore should be indicated soon for fast and complete visual function recovery. Methylprednisolone dose at 500mg for 3 (or 5) days may be an optimal choice for the initial treatment, thus less complication risk but still effective.
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