title: Optic neuritis and the evaluation of visual impairment in multiple sclerosis.
abstract: OBJECTIVE
  This review covers causes of visual impairment in multiple sclerosis (MS), differential diagnosis, and treatment. Emerging technologies are sometimes used in assessing the visual system and may require a neurologist's familiarity. The most common causes are emphasized and discussed in detail, including illustrative cases.
  
  
  RESULTS
  The use of optical coherence tomography as both a clinical and research tool has advanced our understanding of how the afferent visual system is affected by MS.
  
  
  CONCLUSIONS
  Optic neuritis remains one of the most common initial manifestations of MS, although a number of other causes of visual impairment are possible even in the patient with known MS. Some causes of visual impairment are consequences or complications of MS treatment and are particularly important to recognize. Low-contrast letter acuity and optical coherence tomography are techniques or tests emerging from the research arena that may inform care of the patient with MS and are important for the neurologist to be aware of.
authors.affiliation: Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, 9500 Euclid Avenue Building U10, Cleveland, OH 44195, USA. bermelr@ccf.org
authors.forename: Robert A
authors.initials: RA
authors.lastname: Bermel
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Balcer
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001927:Brain Diseases / Q000150:complications; D003937:Diagnosis, Differential; D005074:Evoked Potentials, Visual / Q000502:physiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008487:Medical History Taking; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000175:diagnosis; D009460:Neurologic Examination; D009902:Optic Neuritis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D041623:Tomography, Optical Coherence; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology*
chemical_list: D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone