Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Sep;69(9):2266-2276.
doi: 10.4103/ijo.IJO_3415_20.

Approach to optic neuritis: An update

Swati Phuljhele  1 , Sachin Kedar  2 , Rohit Saxena  1
Affiliations
Review

Approach to optic neuritis: An update

Swati Phuljhele et al. Indian J Ophthalmol. 2021 Sep.

Abstract

Over the past few years, there has been remarkable development in the area of optic neuritis. The discovery of new antibodies has improved our understanding of the pathology of the disease. Antiaquaporin4 antibodies and antimyelin oligodendrocytes antibodies are now considered as distinct entities of optic neuritis with their specific clinical presentation, neuroimaging characteristics, treatment options, and course of the disease. Similarly, there has been a substantial change in the treatment of optic neuritis which was earlier limited to steroids and interferons. The development of new immunosuppressant drugs and monoclonal antibodies has reduced the relapses and improved the prognosis of optic neuritis as well as an associated systemic disease. This review article tends to provide an update on the approach and management of optic neuritis.

Keywords: Myelin oligodendrocytes; multiple sclerosis; neuromyelitis optica; optic neuritis.

PubMed Disclaimer

Conflict of interest statement

None

Figures

Figure 1
Figure 1
Approach to the diagnosis of acute ON
Figure 2
Figure 2
Axial (a) and Coronal (b) T1 weighted contrast and fat saturated MRI sections demonstrate enhancement of the retrobulbar segment of the left optic nerve in a patient with multiple sclerosis
Figure 3
Figure 3
Sagittal (a) and axial (b) T2/FLAIR brain MRI sequences demonstrate focal and confluent foci consistent with demyelinating disease involving corpus callosum and hemispheric white matter in a periventricular location in a patient with multiple sclerosis
Figure 4
Figure 4
Axial (a) and coronal (b) T1 weighted contrast and fat saturated MRI sections demonstrate edema and enhancement of the both optic nerves from the apex to the optic chiasm in patient with AQP-4 IgG positive NMO disease
Figure 5
Figure 5
Axial (a) and Coronal (b) T1 weighted contrast and fat saturated MRI sections demonstrate edema and enhancement of the entire prechiasmatic segment of the right optic nerve. There is also enhancement of the optic nerve sheath and adjacent orbital soft tissue in a patient with MOG IgG optic neuropathy
Figure 6
Figure 6
Protocol for management of ON
See this image and copyright information in PMC

References

    1. Menon V, Saxena R, Misra R, Phuljhele S. Management of optic neuritis. Indian J Ophthalmol. 2011;59:117–22. - PMC - PubMed
    1. Chopra JS, Radhakrishnan K, Sawhney BB, Pal SR, Banerjee AK. Multiple sclerosis in North-west India. Acta Neurol Scand. 1980;62:312–21. - PubMed
    1. Singhal BS. Multiple sclerosis and related demyelinating disorders in Indian context. Neurol India. 1987;35:1–12.
    1. Bhatia M, Behari M, Ahuja GK. Multiple sclerosis in India:AIIMS experience. J Assoc Physicians India. 1996;44:765–7. - PubMed
    1. Verma N, Ahuja GK. Spectrum of multiple sclerosis in Delhi region. J Assoc Physicians India. 1982;30:421–2. - PubMed

Substances