The authors conclude that current evidence does not show a benefit of either intravenous or oral corticosteroids for rate of recovery of vision (in terms of visual acuity, contrast sensitivity, or visual fields). There are a number of reasons why this might be the case. Epidemiology
Optic neuritis typically affects young adults ranging from 18–45 years of age, with a mean age of 30–35 years. There is a strong female predominance. The annual incidence is approximately 5/100,000, with a prevalence estimated to be 115/100,000. Society and culture
In Charles Dickens Bleak House, the main character, Esther Summerville, has a transient episode of visual loss, the symptoms of which  are also seen in people who have optic neuritis. Legal historian Sir William Searle Holdsworth, suggested that the events in Bleak House took place in 1827. In an episode of Dr. Quinn, Medicine Woman ("Season of Miracles", season five), Reverend Timothy Johnson is struck blind by optic neuritis on Christmas Day 1872. He remains blind for the duration of the series. See also
Optic neuropathy
Visual snow

References


== External links ==
In nephrology, vascular access steal syndrome is a syndrome caused by ischemia (not enough blood flow) resulting from a vascular access device (such as an arteriovenous fistula or synthetic vascular graft–AV fistula) that was installed to provide access for the inflow and outflow of blood during hemodialysis. Signs
Pallor
Diminished pulses (distal to the fistula)
Necrosis
Decreased wrist-brachial index (ratio of blood pressure measured in the wrist and the blood pressure measured in the upper arm), especially if below 0.6

Symptoms
Pain distal to the fistula.Symptoms are graded by their severity:
Grade 0: No symptoms of steal
Grade 1: Mild - cool extremity, improvement in hand pulse with access occlusion
Grade 2: Moderate - Ischemic symptoms during dialysis
Grade 3: Severe - Ischemic hand pain outside of dialysis; Ulcers or gangrene of the fingers

Diagnosis
History and physical exam - relief of symptoms with compression of the fistula on exam is highly suggestive of steal
Arteriography
Duplex ultrasound

Treatment
The fistula flow can be restricted through banding, or modulated through surgical revision. Revascularization techniques
Distal Revascularization and Interval Ligation (DRIL) procedure
PAI (Proximalization of the Arterial Inflow)
RUDI (Revision Using Distal Inflow)

Banding techniques
Narrowing suture
Plication
Minimally invasive MILLER banding
Tapering
Surgical bandingIf the above methods fail, the fistula is ligated, and a new fistula is created in a more proximal location in the same limb, or in the contralateral limb. Incidence
DASS occurs in about 1% of AV fistulas and 2.7-8% of PTFE grafts.