title: Atypical Optic Neuritis.
abstract: Classic demyelinative optic neuritis is associated with multiple sclerosis and typically carries a good prognosis for visual recovery. This disorder is well characterized with respect to its presentation and clinical features by baseline data obtained through the optic neuritis treatment trial and numerous other studies. Atypical optic neuritis entails clinical manifestations that deviate from this classic pattern of features. Clinical signs and symptoms that deviate from the typical presentation should prompt consideration of less common etiologies. Atypical features to consider include lack of pain, simultaneous or near-simultaneous onset, lack of response to or relapse upon tapering from corticosteroids, or optic nerve head or peripapillary hemorrhages. The most important alternative etiologies to consider and the steps towards their respective diagnostic evaluations are suggested for these atypical features.
authors.affiliation: Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA. Eric_Gaier@meei.harvard.edu.|Ophthalmology Education, Massachusetts Eye and Ear Infirmary, 3rd floor, 243 Charles St, Boston, MA, 02114, USA. Eric_Gaier@meei.harvard.edu.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Gaier
authors.affiliation: Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA. Katherine_Boudreault@meei.harvard.edu.|Neuro-Ophthalmology Service, Massachusetts Eye and Ear Infirmary, 243 Charles St, Boston, MA, 02114, USA. Katherine_Boudreault@meei.harvard.edu.
authors.forename: Katherine
authors.initials: K
authors.lastname: Boudreault
authors.affiliation: Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA. Joseph_Rizzo@meei.harvard.edu.|Harvard Medical School, Boston, MA, USA. Joseph_Rizzo@meei.harvard.edu.|Neuro-Ophthalmology Service, Massachusetts Eye and Ear Infirmary, 243 Charles St, Boston, MA, 02114, USA. Joseph_Rizzo@meei.harvard.edu.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Rizzo
authors.affiliation: Department of Ophthalmology, Oregon Health & Science University, Portland, OR, USA. falardea@ohsu.edu.|Neuro-Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA. falardea@ohsu.edu.
authors.forename: Julie
authors.initials: J
authors.lastname: Falardeau
authors.affiliation: Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA. Dean_Cestari@meei.harvard.edu.|Harvard Medical School, Boston, MA, USA. Dean_Cestari@meei.harvard.edu.|Neuro-Ophthalmology Service, Massachusetts Eye and Ear Infirmary, 243 Charles St, Boston, MA, 02114, USA. Dean_Cestari@meei.harvard.edu.
authors.forename: Dean M
authors.initials: DM
authors.lastname: Cestari
mesh_terms: D006801:Humans; D007239:Infections; D009103:Multiple Sclerosis / Q000150:complications; D009902:Optic Neuritis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D012008:Recurrence; D014792:Visual Acuity
keywords: Chronic relapsing inflammatory optic neuropathy; Ischemic optic neuropathy; Lyme borreliosis; Neuromyelitis optica (NMO); Optic neuritis; Sarcoidosis