[Management of isolated optic neuritis in France: survey of neurologists and ophthalmologists]. / Prise en charge des névrites optiques isolées en France: enquête auprès des neurologues et des ophtalmologistes.

BACKGROUND: Acute isolated optic neuritis is often the first manifestation of multiple sclerosis (MS). Despite the results of several clinical trials its management remains controversial. With the advent of new disease-modifying agents for the treatment of MS, management of isolated optic neuritis has become more complicated. The goal of this study was to evaluate the current clinical practice of French ophthalmologists and neurologists in the management of acute isolated optic neuritis, and to evaluate the impact of recently published randomized clinical trials on their practice. METHODS: A survey, including 24 questions on the diagnosis and treatment of acute isolated optic neuritis was sent to all neurologists and to a sample of ophthalmologists in France. RESULTS: The responses of 655 neurologists and 141 ophthalmologists were analyzed. This study shows mostly that patients initially present more frequently to ophthalmologists, and are subsequently referred to neurologists. Most optic neuritis patients undergo a brain MRI and a lumbar puncture. Although most patients receive high dose intravenous steroids, up to 15% of neurologists and 21% of ophthalmologists still recommend oral prednisone (1 mg/kg per day). Steroids are often prescribed for the wrong reason, including to improve final visual acuity or decrease the risk of MS. Disease modifying agents are sometimes prescribed outside of the official French recommendations. CONCLUSION: The evidence-based guidelines are only partially followed by practitioners managing patients with acute optic neuritis.

A 10-year retrospective audit of consecutively completed orthodontic treatments in a general dental practice and a hospital orthodontic department.

During 1993 and 1994, the author took part in the South West Orthodontic Clinical Assistant Training Programme and worked as a part-time Clinical Assistant in the Orthodontic Department of the Royal United Hospital, Bath. Following the clinical assistantship the author continued to treat patients in the hospital department but under a General Dental Services contract number. This paper is a personal clinical audit of all the orthodontic cases completed within the GDS by the author since 1990, both in general practice in Westbury, Wiltshire and at the Royal United Hospital (RUH), Bath. The aim of the audit was to evaluate the effectiveness of orthodontic treatment carried out by the author, both in general dental practice and in a hospital orthodontic department, and to compare treatment outcomes with other published results.