title: The impact of the optic neuritis treatment trial on the practices of ophthalmologists and neurologists.
abstract: OBJECTIVE
  To determine whether the Optic Neuritis Treatment Trial (ONTT) results have altered the practice patterns of ophthalmologists and neurologists.
  
  
  METHODS
  Mail survey.
  
  
  METHODS
  A random sample of 987 ophthalmologists and 900 neurologists practicing in the United States were mailed a questionnaire that inquired into decision-making with regard to management of optic neuritis before and after the publication of the ONTT results.
  
  
  METHODS
  Responses received from 202 ophthalmologists and 244 neurologists, a response rate of 47%.
  
  
  RESULTS
  Following the ONTT reports, nearly all ophthalmologists and neurologists have reduced their use of oral prednisone alone, substituting a regimen that includes intravenous methylprednisolone. A large proportion of practitioners in both specialties mistakenly believe that intravenous methylprednisolone treatment improves final visual outcome. Only 7% of neurologists and 36% of ophthalmologists (P = 0.0001) are adhering to the ONTT suggestion to use magnetic resonance imaging as a basis for initiating treatment.
  
  
  CONCLUSIONS
  The ONTT has led to a dramatic reduction in the use of oral prednisone without a preceding course of intravenous methylprednisolone in the treatment of acute optic neuritis. Ophthalmologists and neurologists have changed some of their practices without fully understanding the results of the ONTT.
authors.affiliation: Department of Ophthalmology, W.K. Kellogg Eye Center, School of Medicine, University of Michigan, Ann Arbor 48105, USA. jdt@umich.edu
authors.forename: J D
authors.initials: JD
authors.lastname: Trobe
authors.forename: P C
authors.initials: PC
authors.lastname: Sieving
authors.forename: K E
authors.initials: KE
authors.lastname: Guire
authors.forename: A M
authors.initials: AM
authors.lastname: Fendrick
mesh_terms: D000284:Administration, Oral; D001921:Brain / Q000473:pathology; D003657:Decision Making; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007275:Injections, Intravenous; D008279:Magnetic Resonance Imaging; D008775:Methylprednisolone / Q000627:therapeutic use; D009462:Neurology / Q000592:standards* / Q000706:statistics & numerical data; D009885:Ophthalmology / Q000592:standards* / Q000706:statistics & numerical data; D009902:Optic Neuritis / Q000175:diagnosis / Q000188:drug therapy*; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000706:statistics & numerical data; D011239:Prednisolone / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic / Q000592:standards*; D011795:Surveys and Questionnaires
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone; D008775:Methylprednisolone