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Optic neuritis
Neuro-Ophthalmology
Key Points
- •Pain on eye movements is present in 92% of optic neuritis cases (ONTT) - its absence should prompt consideration of alternative diagnoses such as LHON or compression
- •Oral prednisone alone (1 mg/kg) is CONTRAINDICATED - the ONTT showed it increases the recurrence rate to 30% vs 16% with IV methylprednisolone
- •MRI brain at presentation is the most important prognostic test: ≥1 white matter lesion = 72% MS risk at 15 years; 0 lesions = 25% MS risk (ONTT 15-year follow-up)
- •Neuroretinitis (disc edema + macular star) is NOT associated with MS - it is typically caused by Bartonella henselae (cat-scratch disease)
- •Visual prognosis is excellent: 95% recover to 20/40 or better within 1 year, but subtle deficits (contrast, colour, VEP latency) persist in ≥90% (ONTT)
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Keep reading Optic neuritis
17 more sections are included with the Clinical plan.
- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Risk factors and associations