Optic neuritis - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Optic neuritis (ON) may involve the retrobulbar (retrobulbar neuritis) or the intrabulbar (papillitis) portion of the optic nerve, or both.
Idiopathic ON, the most common form of ON, is an inflammatory optic neuropathy in the absence of evidence of a systemic inflammatory disease.
May occur in isolation or be a manifestation, often the first, of multiple sclerosis (MS).
Investigations including MRI of the brain can help predict the risk of conversion to MS and can dictate early intervention with disease-modifying treatments (interferon-beta, glatiramer acetate) that reduces the risk of conversion to MS.
Acute treatment for idiopathic ON includes high-dose oral or intravenous corticosteroid treatment.

Papillitis in optic neuritis

From the personal collections of Dr Cris S. Constantinescu and Dr Thomas M. Bosley

Quick Reference

History & Exam
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Diagnostics Tests
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Papillitis in optic neuritis
Transverse MRI showing typical white matter periventricular hyperintense lesions in the brain parenchyma

Citations

Key Articles

Petzold A, Fraser CL, Abegg M, et al. Diagnosis and classification of optic neuritis. Lancet Neurol. 2022 Dec;21(12):1120-34.[Abstract]
American Academy of Ophthalmology. Optic neuritis - 2012. Jul 2012 [internet publication].[Full Text]
Beck RW, Cleary PA, Anderson MM Jr, et al. A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis. The Optic Neuritis Study Group. N Engl J Med. 1992 Feb 27;326(9):581-8.[Abstract]
Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018 Feb;17(2):162-73.[Abstract][Full Text]
Sellner J, Boggild M, Clanet M, et al. EFNS guidelines on diagnosis and management of neuromyelitis optica. Eur J Neurol. 2010 Aug;17(8):1019-32.[Abstract][Full Text]
Gal RL, Vedula SS, Beck R. Corticosteroids for treating optic neuritis. Cochrane Database Syst Rev. 2015 Aug 14;(8):CD001430.[Abstract][Full Text]

Referenced Articles

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