To the Editor.
—Neuro-ophthalmic opinion seems to discourage the routine use of steroids in optic neuritis. Three well-designed controlled studies are generally cited in support of this opinion.1-3 All three studies were limited by sample size.The number of patients seen for at least six months in these studies ranged from 44 to 54. The patients were divided more or less equally into treatment and control groups. Thus, the individual group sizes varied from 21 to 28. Let us assume, for a moment, that each group size was 30. What would be the chance of missing a clinically significant effect of steroids in a study of this size? We assume that the clinical attribute of interest is recovery to 20/20 visual acuity within six months after the acute attack; we know that this occurs in about 70% of untreated cases.4 We believe a clinically significant effect of steroids
Cox TA, Woolson RF. Steroid Treatment of Optic Neuritis. Arch Ophthalmol. 1981;99(2):338. doi:10.1001/archopht.1981.03930010340028