Treatment of Optic Neuropathy With Megadose Corticosteroids

To the Editor.  —I read with interest the article in the Archives entitled "Optic Neuropathy in Systemic Lupus Erythematosus" by Jabs et al¹ and totally concur with their statement that "in virtually any patient, particularly young women, who develop any type of optic neuropathy, whether unilateral or bilateral, the possibility of SLE [systemic lupus erythematosus] must be considered, and an appropriate history, examination, and serologic studies may be required." I believe, but cannot yet document, that this entity is much more common than we believe and may be a presenting manifestation of an autoimmune disease years before the appearance of convincing clinical signs, symptoms, and serologic abnormalities.I have had excellent success restoring vision in patients with both suspected and known autoimmune disease and visual loss due to an optic neuropathy with pulse dosage of megadose intravenous methylprednisolone.² Similar success has been reported by others.³ I suggest