Compressive optic neuropathy: echographic study in retrobulbar optic neuritis

Optic neuritis can be a challenging diagnostic and therapeutic problem. Recovery can be obtained with steroid therapy, although a recurrence-free follow-up has been obtained without steroid therapy. This suggests that a mechanism other than simple inflammation is involved in this disease. We examined 60 patients who had a clinical diagnosis of retrobulbar optic neuritis with digitalized A-scan equipment in an attempt to clarify this other mechanism. Interestingly, among these patients we found seven cases of compressive optic neuropathy. Even though further studies are required to correlate this condition to the recovery of visual acuity, compressive optic neuropathy is an important negative prognostic factor. In addition, the finding of compressive optic neuropathy in patients affected by optic neuritis might have a bearing on why recovery or not of visual acuity in patients with optic neuritis occurs regardless of steroid therapy. Should this be the case, steroid therapy could be administered according the presence of this condition.