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Optic neuritis and multiple sclerosis

Optic neuritis is an acute inflammatory demyelinating disorder of the optic nerve. It is most frequently found in young females and represents a common clinical condition in neurology as well as ophthalmology. In parts of the world where multiple sclerosis is prevalent, it is most commonly considered to be the cause of optic neuritis. The main symptoms associated with optic neuritis include unilateral, subacute, visual loss accompanied with pain with no systemic or other related neurological symptoms. It may be associated with demyelinating disorders of the central nervous system namely multiple sclerosis as well as neuromyelitis optica. Optic neuritis may be the initial manifestation of multiple sclerosis in approximately 20% of patients and in fact, in 50% of patients with multiple sclerosis, optic neuritis may appear throughout the course of the disease. Further, the risk of developing multiple sclerosis in patients with optic neuritis is estimated at about 50% after 15 years of follow-up. The risk is higher in cases where oligoclonal bands are found on cerebrospinal fluid protein electrophoresis without corresponding bands in serum and abnormalities typical of multiple sclerosis observed on magnetic resonance imaging of the brain. Due to observed relationship, it is important to ascertain an accurate diagnosis and appropriate treatment of optic neuritis as well as assessing the likelihood of multiple sclerosis development in all patients. In those patients, monitoring by both the ophthalmologist and the neurologist must be continued for a timely decision on further management.

optic neuritis ; multiple sclerosis ; diagnosis ; treatment

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