{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T06:06:25Z","timestamp":1778393185659,"version":"3.51.4"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Ophthalmol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Optic neuritis (ON) is a common cause of visual loss in adults. It is commonly related to or occurs in the scenario of a demyelinating disease. Although treatment leads to visual recovery, diagnosis and treatment need to occur quickly, especially in lower-resource countries, where systems expect delays in care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The goal of this study was to examine health-system delays in ON diagnosis and treatment and their effects on visual recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective review involved 100 cases of ON seen in a tertiary referral hospital from 2016 to 2023. Diagnosis was made of clinical features with confirmation by neuro-ophthalmological evaluation. MRI and visual evoked potentials (VEPs) were obtained if they were within reach. Visual recovery was defined as improvement of \u22653 Snellen lines at 3 months. Patients were given intravenous methylprednisolone (1 g\/day for 3\u20135 days) and a tapered course of oral prednisolone. Delayed treatment was defined as the start of corticosteroids &amp;gt; 14 days after symptom onset, which was established for patients who did not start steroids on initial presentation. Logistic regression and ROC analysis were used to determine predictors of complete recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>58% of patients experienced delayed treatment and had lower rates of complete visual recovery (31.0% vs. 66.7%, p &amp;lt; 0.01). Delayed treatment (OR 0.45; 95% CI 0.21\u20130.89) and baseline poor BCVA independently predicted poor visual recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In low-resource settings, the short-term visual outcomes of ON are worse with a delay in management. Prompt initiation of corticosteroids and improved referral pathways may aid in maximizing the recovery rate.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fopht.2025.1642288","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T05:14:37Z","timestamp":1763702077000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Public health implications of delayed diagnosis and treatment of optic neuritis in low-resource settings: a retrospective study of visual recovery outcomes"],"prefix":"10.3389","volume":"5","author":[{"given":"Ruimei","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qingfen","family":"Qi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuangnong","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiuwen","family":"Yan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clement","family":"Arthur","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1016\/S1474-4422(13)70259-X","article-title":"Optic neuritis","volume":"13","author":"Toosy","year":"2014","journal-title":"Lancet Neurol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(14)70115-X","article-title":"The neuro-ophthalmology of multiple sclerosis","volume":"13","author":"Waldman","year":"2014","journal-title":"Lancet Neurol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.45.2.244","article-title":"Optic neuritis: a population-based study in Olmsted County, Minnesota","volume":"45","author":"Rodriguez","year":"1995","journal-title":"Neurology"},{"key":"B4","article-title":"Optic neuropathies","volume-title":"Ophthalmology","author":"Lee","year":"2014"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp053247","article-title":"Clinical practice. Optic neuritis","volume":"354","author":"Balcer","year":"2006","journal-title":"N Engl J Med"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1992.01080150043025","article-title":"The optic neuritis treatment trial","volume":"110","author":"Almasaud","year":"1992","journal-title":"Arch Ophthalmol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.09-3507","article-title":"Causes of blindness and visual impairment in Nigeria: the Nigeria national blindness and visual impairment survey","volume":"50","author":"Abdull","year":"2009","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30488-5","article-title":"The Lancet Global Health Commission on Global Eye Health: vision beyond 2020","volume":"9","author":"Burton","year":"2021","journal-title":"Lancet Glob Health"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2008.150425","article-title":"Visual impairment and vision-related quality of life in working-age adults: findings from the 1958 British birth cohort","volume":"93","author":"Rahi","year":"2009","journal-title":"Br J Ophthalmol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-4-97","article-title":"Quality of life in age-related macular degeneration: a review of the literature","volume":"4","author":"Mitchell","year":"2006","journal-title":"Health Qual Life Outcomes"},{"key":"B11","article-title":"Why are we addressing gender issues in vision loss","volume":"22","author":"Courtright","year":"2009","journal-title":"Community Eye Health"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-024-21047-x","article-title":"Global burden of low vision and blindness due to age-related macular degeneration from 1990 to 2021 and projections for 2050","volume":"24","author":"Zhang","year":"2024","journal-title":"BMC Public Health"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(21)00212-6","article-title":"Keeping an eye on eye care: monitoring progress towards effective coverage","volume":"9","author":"Keel","year":"2021","journal-title":"Lancet Glob Health"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2011-301378","article-title":"The number of ophthalmologists in practice and training worldwide: a growing gap despite more than 200,000 practitioners","volume":"96","author":"Resnikoff","year":"2012","journal-title":"Br J Ophthalmol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1111\/cxo.12541","article-title":"Optical coherence tomography in optic neuritis and multiple sclerosis: current clinical use and future perspectives","volume":"101","author":"Chan","year":"2018","journal-title":"Clin Exp Optom"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.4103\/ijo.IJO_290_21","article-title":"Clinico-epidemiologic characteristics of optic neuritis in a tertiary eye centre in Eastern India based on the status of serum aquaporin-4 antibody","volume":"70","author":"Ambasta","year":"2022","journal-title":"Indian J Ophthalmol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"e0269514","DOI":"10.1371\/journal.pone.0269514","article-title":"Optic neuritis: A South African hospital-based prospective study protocol","volume":"17","author":"Ally","year":"2022","journal-title":"PloS One"},{"key":"B18","doi-asserted-by":"publisher","first-page":"e81140","DOI":"10.7759\/cureus.81140","article-title":"Optic neuritis presentation and outcomes: A single-center experience from northern Saudi Arabia","volume":"17","author":"Almasaud","year":"2025","journal-title":"Cureus"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ajo.2021.05.016","article-title":"The 2021 national eye institute strategic plan: vision for the future","volume":"226","author":"Chiang","year":"2021","journal-title":"Am J Ophthalmol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3390\/ijms24086977","article-title":"Optic neuropathies: current and future strategies for optic nerve protection and repair","volume":"24","author":"Miller","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3390\/ijms23179769","article-title":"Treatment and relapse prevention of typical and atypical optic neuritis","volume":"23","author":"Saitakis","year":"2022","journal-title":"Int J Mol Sci"},{"key":"B22","volume-title":"Advancements in ADEM and optic neuritis treatment with TRE-515","author":"Schultz","year":"2024"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S294428","article-title":"A systematic review of current teleophthalmology services in New Zealand compared to the four comparable countries of the United Kingdom, Australia, United States of America (USA) and Canada","volume":"15","author":"Walsh","year":"2021","journal-title":"Clin Ophthalmol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2023.2258149","article-title":"Artificial intelligence for telemedicine diabetic retinopathy screening: a review","volume":"55","author":"Nakayama","year":"2023","journal-title":"Ann Med"},{"key":"B25","first-page":"1281","article-title":"Ischemic Optic Neuropathy: A Review of Current and Potential Future Pharmacotherapies","volume-title":"Pharmaceuticals (Basel)","author":"Badla","year":"2024"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1038\/s41433-025-03683-8","article-title":"Prevalence of pediatric and adult optic neuritis in the United States from 2016 to 2023","volume":"39","author":"Abbass","year":"2025","journal-title":"Eye (Lond)"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.70565","article-title":"The Benefits and Challenges of Implementing Teleophthalmology in Low-Resource Settings","volume":"16","author":"Khan","year":"2024","journal-title":"A Systematic Review. Cureus"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.3390\/ijms23105751","article-title":"Using noninvasive electrophysiology to determine time windows of neuroprotection in optic neuropathies","volume":"23","author":"Porciatti","year":"2022","journal-title":"Int J Mol Sci"},{"key":"B29","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1038\/s41467-023-44676-z","article-title":"Autonomous artificial intelligence increases screening and follow-up for diabetic retinopathy in youth: the ACCESS randomized control trial","volume":"15","author":"Wolf","year":"2024","journal-title":"Nat Commun"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2023.07.012","article-title":"Updates and controversies in the management of acute optic neuritis","volume":"34","author":"Miller","year":"2023","journal-title":"Curr Opin Ophthalmol"}],"container-title":["Frontiers in Ophthalmology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fopht.2025.1642288\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T05:14:39Z","timestamp":1763702079000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fopht.2025.1642288\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,21]]},"references-count":30,"alternative-id":["10.3389\/fopht.2025.1642288"],"URL":"https:\/\/doi.org\/10.3389\/fopht.2025.1642288","relation":{},"ISSN":["2674-0826"],"issn-type":[{"value":"2674-0826","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,21]]},"article-number":"1642288"}}