Management of acute optic neuritis: A survey of neurologists and ophthalmologists in Australia and New Zealand

Recent studies suggest that evidence-based medicine is not well translated into everyday practice. Studies of optic neuritis (ON) have generated clear treatment guidelines. Therefore, a survey was mailed to all Australian and New Zealand neurologists and ophthalmologists to evaluate the impact of recent studies on clinical practice. The response rate was 38.9%. Neurologists were more likely to use high dose corticosteroids and disease modifying agents (DMAs), and were more likely to be aware of relevant literature concerning DMAs. Both groups contained a significant minority of practitioners who would use corticosteroids for reasons not substantiated by available evidence. We conclude that most practitioners manage optic neuritis according to existing evidence and guidelines, but many do not. It is essential to instigate high-quality training programs to keep practitioners up-to-date, thereby optimising patient care and justifying the time and expense of large-scale clinical trials.