Atypical Optic Neuritis

Overview

Journal Curr Neurol Neurosci Rep

Specialty Neurology

Date 2015 Oct 16

PMID 26467052

Citations 12

Authors

Eric D Gaier

Katherine Boudreault

Joseph F Rizzo 3rd

Julie Falardeau

Dean M Cestari

Affiliations

Soon will be listed here.

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.

Citing Articles

Ocular Ultrasound in the Diagnosis of Optic Neuropathies: A Review of the Literature.

Coppola A, Abbinante G, De Pascale I, Gagliardi V, Salerno G, Pellegrino A J Pers Med. 2024; 14(9).

PMID: 39338203 PMC: 11433128. DOI: 10.3390/jpm14090949.

Acute Optic Neuritis: An Update on Approach and Management.

Jamali Dogahe S, Pakravan P, Pakravan M J Ophthalmic Vis Res. 2024; 18(4):433-440.

PMID: 38250236 PMC: 10794797. DOI: 10.18502/jovr.v18i4.14556.

Clinical spectrum of first episode of optic neuritis in a tertiary care hospital in Southern India - A retrospective analysis.

Vallinayagam M, Deepikadevi S, Sainath D, Balla S Saudi J Ophthalmol. 2023; 37(1):20-24.

PMID: 36968764 PMC: 10032289. DOI: 10.4103/sjopt.sjopt_166_21.

The Importance of Optical Coherence Tomography in the Diagnosis of Atypical or Subclinical Optic Neuritis: A Case Series Study.

Huang-Link Y, Yang G, Gustafsson G, Gauffin H, Landtblom A, Mirabelli P J Clin Med. 2023; 12(4).

PMID: 36835847 PMC: 9961647. DOI: 10.3390/jcm12041309.

Relapsing-remitting Optic Neuropathy in an HIV-infected Patient: Secondary Auto-immune Optic Neuropathy or Infectious Optic Neuropathy? A Case Report and Review of the Literature.

Coutel M, Flamant R, Sankari S, Belkhir L, Duprez T, Boschi A Neuroophthalmology. 2022; 46(4):236-241.

PMID: 35859626 PMC: 9291713. DOI: 10.1080/01658107.2021.1933078.

References

Doro S, Lessell S . Cup-disc ratio and ischemic optic neuropathy. Arch Ophthalmol. 1985; 103(8):1143-4. DOI: 10.1001/archopht.1985.01050080055019. View

Yu Z, Kryzer T, Griesmann G, Kim K, Benarroch E, Lennon V . CRMP-5 neuronal autoantibody: marker of lung cancer and thymoma-related autoimmunity. Ann Neurol. 2001; 49(2):146-54. View

Frohman L, Guirgis M, Turbin R, Bielory L . Sarcoidosis of the anterior visual pathway: 24 new cases. J Neuroophthalmol. 2003; 23(3):190-7. DOI: 10.1097/00041327-200309000-00002. View

Mikkila H, Seppala I, Viljanen M, Peltomaa M, Karma A . The expanding clinical spectrum of ocular lyme borreliosis. Ophthalmology. 2000; 107(3):581-7. DOI: 10.1016/s0161-6420(99)00128-1. View

Mafee M, Dorodi S, Pai E . Sarcoidosis of the eye, orbit, and central nervous system. Role of MR imaging. Radiol Clin North Am. 1999; 37(1):73-87, x. DOI: 10.1016/s0033-8389(05)70079-8. View

SCHLOSSMAN A, Phillips C . Optic neuritis in relation to demyelinating diseases; a clinical study. Am J Ophthalmol. 1954; 37(4):487-94. DOI: 10.1016/0002-9394(54)92198-4. View

Warner J, Lessell S, Rizzo 3rd J, Newman N . Does optic disc appearance distinguish ischemic optic neuropathy from optic neuritis?. Arch Ophthalmol. 1997; 115(11):1408-10. DOI: 10.1001/archopht.1997.01100160578009. View

Beck R, Cleary P, Backlund J . The course of visual recovery after optic neuritis. Experience of the Optic Neuritis Treatment Trial. Ophthalmology. 1994; 101(11):1771-8. DOI: 10.1016/s0161-6420(94)31103-1. View

Waters P, McKeon A, Leite M, Rajasekharan S, Lennon V, Villalobos A . Serologic diagnosis of NMO: a multicenter comparison of aquaporin-4-IgG assays. Neurology. 2012; 78(9):665-71. PMC: 3286228. DOI: 10.1212/WNL.0b013e318248dec1. View

10.

. Visual function 15 years after optic neuritis: a final follow-up report from the Optic Neuritis Treatment Trial. Ophthalmology. 2007; 115(6):1079-1082.e5. DOI: 10.1016/j.ophtha.2007.08.004. View

11.

Rizzo 3rd J, Andreoli C, Rabinov J . Use of magnetic resonance imaging to differentiate optic neuritis and nonarteritic anterior ischemic optic neuropathy. Ophthalmology. 2002; 109(9):1679-84. DOI: 10.1016/s0161-6420(02)01148-x. View

12.

Beck R, Trobe J, Moke P, Gal R, Xing D, Bhatti M . High- and low-risk profiles for the development of multiple sclerosis within 10 years after optic neuritis: experience of the optic neuritis treatment trial. Arch Ophthalmol. 2003; 121(7):944-9. DOI: 10.1001/archopht.121.7.944. View

13.

Wingerchuk D, Lennon V, Pittock S, Lucchinetti C, Weinshenker B . Revised diagnostic criteria for neuromyelitis optica. Neurology. 2006; 66(10):1485-9. DOI: 10.1212/01.wnl.0000216139.44259.74. View

14.

Kitley J, Waters P, Woodhall M, Leite M, Murchison A, George J . Neuromyelitis optica spectrum disorders with aquaporin-4 and myelin-oligodendrocyte glycoprotein antibodies: a comparative study. JAMA Neurol. 2014; 71(3):276-83. DOI: 10.1001/jamaneurol.2013.5857. View

15.

Chao J, Khurana R, Fawzi A, Reddy H, Rao N . Syphilis: reemergence of an old adversary. Ophthalmology. 2006; 113(11):2074-9. DOI: 10.1016/j.ophtha.2006.05.048. View

16.

Rizzo 3rd J, Lessell S . Risk of developing multiple sclerosis after uncomplicated optic neuritis: a long-term prospective study. Neurology. 1988; 38(2):185-90. DOI: 10.1212/wnl.38.2.185. View

17.

Rizzo 3rd J, Lessell S . Optic neuritis and ischemic optic neuropathy. Overlapping clinical profiles. Arch Ophthalmol. 1991; 109(12):1668-72. DOI: 10.1001/archopht.1991.01080120052024. View

18.

Beck R, Cleary P, Anderson Jr M, Keltner J, Shults W, Kaufman D . A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis. The Optic Neuritis Study Group. N Engl J Med. 1992; 326(9):581-8. DOI: 10.1056/NEJM199202273260901. View

19.

Yu-Wai-Man P, Griffiths P, Hudson G, Chinnery P . Inherited mitochondrial optic neuropathies. J Med Genet. 2008; 46(3):145-58. PMC: 2643051. DOI: 10.1136/jmg.2007.054270. View

20.

Mealy M, Wingerchuk D, Palace J, Greenberg B, Levy M . Comparison of relapse and treatment failure rates among patients with neuromyelitis optica: multicenter study of treatment efficacy. JAMA Neurol. 2014; 71(3):324-30. DOI: 10.1001/jamaneurol.2013.5699. View