The authors reviewed a series of 10 consecutive patients treated with plasma e xchange (PE) for acute, severe optic neuritis (ON) largely unresponsive to previ ous high dose IV glucocorticosteroids. PE was associated with an improvement of visual acuity according to the study criteria in 7 of 10 patients. On follow u p, three of these patients continued to improve, two remained stable, and two ha d worsened again. PE may be beneficial as an escalating treatment in a subset of patients with severe ON. A controlled trial is warranted.
