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18. 19. 20. 21. 22. References Beck RW, Chandler DL, Cole SR et al (2002) Interferon β-1a for early multiple sclerosis: CHAMPS trial subgroup analyses. Ann Neurol 51:481–490 Bermel R, Puli S, Rudick R et al (2005) Gray mater MRI T2 hypointensity predicts longitudinal atrophy in multiple sclerosis. Arch Neurol 62:1371–1376 Boomer JA, Siatkowski RM (2003) Optic neuritis in adults and children. Semin Ophthalmol 18:174–180 Brady KM, Brar AS, Lee AG et al (1999) Optic neuritis in children: clinical features and visual outcome.

The 24-month follow-up data from the study confirmed the initial 6 months report. This technique is not currently recommended for the treatment of NAION. Transvitreal radial optic neurotomy has been proposed as a therapy for both central retinal vein occlusion (CRVO) and NAION [58]. The procedure involves a pars plana vitrectomy and induced posterior vitreous detachment, associated with a stab incision at the nasal margin of the optic disc, with the purpose of opening the scleral canal and relieving compression of an edematous optic nerve.

It has been emphasized that, once axonal damage occurs, it may result in permanent neurological deficits. The issue of axonal damage and gray matter atrophy is at the center of the ongoing debate over whether to intervene early with immunomodulatory agents in patients with clinically isolated syndromes [4, 27], especially those predicted to be at high risk for the subsequent development of MS. Results of the CHAMPS [16] ETOMS [18], and BENEFIT [26, 56] studies suggest that patients with optic neuritis and abnormal baseline MRI (“high-risk patients”) should be considered for interferon beta therapy.

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