Diagnosis and treatment of multiple sclerosis: Ocular manifestations of multiple sclerosis

doi:10.1136/bmj.332.7542.668-b

BMJ 2006;332:668 (18 March), doi:10.1136/bmj.332.7542.668-b

Letter

Diagnosis and treatment of multiple sclerosis

Ocular manifestations of multiple sclerosis

The first 150 words of the full text of this article appear below.

EDITOR—Murray reviewed the diagnosis and treatment ofmultiple sclerosis.¹ Ocular manifestations are sometimes thefirst sign of the disease, including optic neuritis, internuclearophthalmoplegia, ocular motor cranial nerve palsies, trigeminaland facial nerve palsies, nystagmus, pars planitis, and retinalperiphlebitis.² These conditions may predict additional demyelinatingevents.

The optic neuritis treatment trial is a randomised 15 centretrial of 457 patients to assess the effects of corticosteroidsin optic neuritis.^{3 4} The results showed that intravenous methylprednisolonehastened the recovery of visual function after optic neuritiswithout significantly improving the long term final visual acuity.The trial also showed that while intravenous steroids reducedthe incidence of symptomatic multiple sclerosis, oral steroidswere associated with an increased recurrence of optic neuritis.

The treatment of intermediate uveitis due to multiple sclerosisis indicated when the visual acuity is 6/12 or less due to cystoidmacular oedema. This includes systemic and . . . [Full text of this article]

Mohammad T Masoud, senior house officer, ophthalmology

Stirling Royal Infirmary, Stirling FK8 2AU seham_tm@hotmail.com