AUTHOR=Li Ruimei , Qi Qingfen , Li Shuangnong , Yan Xiuwen , Arthur Clement 

TITLE=Public health implications of delayed diagnosis and treatment of optic neuritis in low-resource settings: a retrospective study of visual recovery outcomes

JOURNAL=Frontiers in Ophthalmology

VOLUME=Volume 5 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/ophthalmology/articles/10.3389/fopht.2025.1642288

DOI=10.3389/fopht.2025.1642288

ISSN=2674-0826

ABSTRACT=BackgroundOptic neuritis (ON) is a common cause of visual loss in adults. It is commonly related to or occurs in the scenario of a demyelinating disease. Although treatment leads to visual recovery, diagnosis and treatment need to occur quickly, especially in lower-resource countries, where systems expect delays in care.PurposeThe goal of this study was to examine health-system delays in ON diagnosis and treatment and their effects on visual recovery.MethodsThis retrospective review involved 100 cases of ON seen in a tertiary referral hospital from 2016 to 2023. Diagnosis was made of clinical features with confirmation by neuro-ophthalmological evaluation. MRI and visual evoked potentials (VEPs) were obtained if they were within reach. Visual recovery was defined as improvement of ≥3 Snellen lines at 3 months. Patients were given intravenous methylprednisolone (1 g/day for 3–5 days) and a tapered course of oral prednisolone. Delayed treatment was defined as the start of corticosteroids > 14 days after symptom onset, which was established for patients who did not start steroids on initial presentation. Logistic regression and ROC analysis were used to determine predictors of complete recovery.Results58% of patients experienced delayed treatment and had lower rates of complete visual recovery (31.0% vs. 66.7%, p < 0.01). Delayed treatment (OR 0.45; 95% CI 0.21–0.89) and baseline poor BCVA independently predicted poor visual recovery.ConclusionIn low-resource settings, the short-term visual outcomes of ON are worse with a delay in management. Prompt initiation of corticosteroids and improved referral pathways may aid in maximizing the recovery rate.