Acute inflammatory demyelinating optic neuritis: current concepts in diagnosis and management.
BACKGROUND
Optic neuritis (ON), defined as an inflammatory demyelinating optic neuropathy, is a frequent cause of visual loss owing to optic nerve dysfunction in young or middle-aged patients. ON can be seen in isolation or in association with multiple sclerosis (MS). Highlighting the importance of this association is the fact that approximately 20% of patients with MS will present with ON.


METHODS
Review was conducted of the literature and pertinent clinical trials.


CONCLUSIONS
Although the vision prognosis of patients with ON is excellent, with or without the use of corticosteroids, a minority of patients will suffer from significantly poor vision. ON may be the heralding manifestation of MS; the risk stratification for the future development of MS in patients presenting with ON can be determined by the number of white matter lesions on the baseline cerebral magnetic resonance imaging study. To date, 2 randomized, placebo-controlled studies have found that patients with a clinically isolated demyelinating syndrome, such as ON, at risk for MS, may benefit from the early institution of a disease-modifying drug.
Bhatti
M Tariq
MT
Department of Ophthalmology, University of Florida College of Medicine, Gainesville, Florida 32610, USA. tbhatti@eye.ufl.edu
Schmitt
Nicholas J
NJ
Beatty
Randall L
RL
D000208:Acute Disease; D000328:Adult; D003711:Demyelinating Diseases / Q000175:diagnosis / Q000188:drug therapy; D003937:Diagnosis, Differential; D004333:Drug Administration Routes; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D009900:Optic Nerve / Q000473:pathology; D009902:Optic Neuritis / Q000175:diagnosis / Q000188:drug therapy; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D014792:Visual Acuity
D005938:Glucocorticoids; D011239:Prednisolone; D008775:Methylprednisolone