Clinical Profile of Acute Optic Neuritis in a Tertiary Eye Hospital in Bangladesh

Abstract

Background: Optic neuritis (ON) is an inflammatory or demyelinating disorder of the optic nerve that presents with acute visual loss and periocular pain. Its clinical profile varies across regions due to genetic, environmental, and demographic influences. Aim: This study aimed to determine the demographic and clinical characteristics of patients with ON at a tertiary eye hospital in Bangladesh. Methods: A descriptive cross-sectional study was conducted at the Neuro-ophthalmology Department of the Ispahani Islamia Eye Institute and Hospital, Dhaka, Bangladesh, between July 2019 and June 2020. A total of 100 patients (139 affected eyes) diagnosed with ON were included in the study. Demographic data, complaints, visual acuity, color vision, pupillary responses, visual fields, and fundus findings were recorded. Statistical analysis was performed using SPSS v20.0. Results: Among 100 patients (54 males, 46 females; mean age 30±12.95 years), most were aged 40–49 years (34%). All patients presented with acute dimness of vision, while 22% reported periocular pain and 12% fever. Nearly half (47.5%) had visual acuity <3/60, and 73.4% showed reduced color vision. Central scotoma (46.8%) was the most common visual-field defect. Relative afferent pupillary defects were noted in 46.8% of eyes. Papillitis, retrobulbar neuritis, and neuroretinitis accounted for 86 %, 10%, and 4% of the cases, respectively. Unilateral ON (61%) was more frequent than bilateral ON (39%). Conclusion: Papillitis was the predominant type of ON in this cohort, with unilateral involvement being more common. Unilateral papillitis occurred more frequently in middle-aged men (40–49 years). These findings provide insights that may support the early diagnosis and improved management of ON in Bangladesh.