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Review
. 2021 Jan;69(1):27-35.
doi: 10.4103/ijo.IJO_451_20.

Atypical optic neuritis: An overview

Prathama Sarkar  1 , Amit Mehtani  1 , H C Gandhi  1 , Vinita Dubey  1 , Parag Maroti Tembhurde  1 , Mohit Kumar Gupta  1
Affiliations
Review

Atypical optic neuritis: An overview

Prathama Sarkar et al. Indian J Ophthalmol. 2021 Jan.

Abstract

Optic neuritis (ON) refers to conditions that involve inflammation of the optic nerve. Various autoantibodies have been found, which are associated with central nervous system inflammatory disorders and have provided much information about the immune targets and mechanisms that impact the prognosis, treatment, and recurrence of atypical ON. Therefore, neurologists and ophthalmologists together should work to find out clinical, laboratory, and imaging findings that may provide important clues to the etiology of atypical ON and its management. Various biomarkers have been identified to confirm and distinguish atypical optic neuritis from others. The purpose of this review is to present the current scenario of atypical ON and its clinical management.

Keywords: Atypical optic neuritis; infectious optic neuritis; myelin oligodendrocyte glycoprotein antibody; neuromyelitis optica; optic neuritis.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
(A) Longitudinally extensive spinal cord lesions detected by MRI in AQP4- seropositive NMOSD patients. (a) T2W central longitudinally extensive cervical lesion. (b) T1W lesion with gadolinium showing multiple hypointensities in cervical cord. (c) T2W cervical lesion extending to brainstem. (d) Longitudinally extensive spinal cord atrophy of cervical cord. Citation: Lana-Peixoto, Marco A, and Natália Talim. “Neuromyelitis Optica Spectrum Disorder and Anti-MOG Syndromes.” Biomedicines vol. 7,2 42.12 Jun. 2019. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6631227/). (B) Optic nerve abnormalities on MRI in AQP4-seropositive NMOSD patients. (a) Sagittal T1W MRI shows edematous gadolinium-enhancing optic nerve lesion extending from the eye to the intracranial segment. (b) Axial T1W extensive gadolinium-enhancing lesion in both optic nerves. (c) Coronal T1W MRI shows edematous gadolinium-enhancing lesion in the optic chiasm. Citation: Lana-Peixoto, Marco A, and Natália Talim. “Neuromyelitis Optica Spectrum Disorder and Anti-MOG Syndromes.” Biomedicines vol. 7,2 42. 12 Jun. 2019. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6631227/). (C) MRI abnormalities in anti-MOG syndrome. (a) Axial T1W MRI reveals longitudinal extensive gadolinium enhancement of both optic nerves. (b) Coronal T2W MRI shows hyperintense thickening of perioptic nerve sheath. (c) Sagittal T2/FLAIR-weighted image shows large fluffy lesion in the medulla. Citation: Lana-Peixoto, Marco A, and Natália Talim. “Neuromyelitis Optica Spectrum Disorder and Anti-MOG Syndromes.” Biomedicines vol. 7,2 42. 12 Jun. 2019. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6631227/)
Figure 2
Figure 2
OCT image of MS-ON (b) OCT image of NMO-ON. NMO-ON showing more severe damage compared to patients with MS. Citation: Tian G, Li Z, Zhao G, Feng C, Li M, Huang Y, Sun X. Evaluation of Retinal Nerve Fiber Layer and Ganglion Cell Complex in Patients with Optic Neuritis or Neuromyelitis Optica Spectrum Disorders Using Optical Coherence Tomography in a Chinese Cohort. J Ophthalmol. 2015;2015:832784
See this image and copyright information in PMC

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