optic neuritis

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Introduction

Inflammation, demyelination or infection of the optic nerve anterior to the optic chiasm. When the intraocular portion of the optic nerve is involved, the disorder is termed papillitis. If the retina is involved, the disorder is termed optic neuro- retinitis. Otherwise the disorder is termed retrobulbar neuritis.

Etiology

Epidemiology

  • 3-4/100,000 person years
  • age 21-30 most common
  • female > male[7]

Clinical manifestations

Laboratory

* distinguishes neuromyelitis optica from multiple sclerosis

Diagnostic procedures

Radiology

* cannot detect multiple sclerosis, so do not order[8]

Differential diagnosis

Management

More general terms

More specific terms

References

  1. Harrison's Principles of Internal Medicine, 13th ed. Companion Handbook, Isselbacher et al (eds), McGraw-Hill Inc. NY, 1995, pg 829-39
  2. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 76-77
  3. Geriatrics at your Fingertips, 13th edition, 2011 Reuben DB et al (eds) American Geriatric Society
  4. 4.0 4.1 4.2 Medical Knowledge Self Assessment Program (MKSAP) 16, 18. American College of Physicians, Philadelphia 2012, 2018.
  5. Beck RW, Cleary PA, Anderson MM Jr et al A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis. The Optic Neuritis Study Group. N Engl J Med. 1992 Feb 27;326(9):581-8. PMID: https://www.ncbi.nlm.nih.gov/pubmed/1734247
  6. 6.0 6.1 Morrow SA, Fraser JA, Day C et al Effect of Treating Acute Optic Neuritis With Bioequivalent Oral vs Intravenous Corticosteroids. A Randomized Clinical Trial. JAMA Neurol. Published online March 5, 2018. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29507942 https://jamanetwork.com/journals/jamaneurology/fullarticle/2673723
  7. 7.0 7.1 7.2 7.3 7.4 7.5 Braithwaite T, Subramanian A, Petzold A et al. Trends in optic neuritis incidence and prevalence in the UK and association with systemic and neurologic disease. JAMA Neurol 2020 Oct 5; 77:1514. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33017023 https://jamanetwork.com/journals/jamaneurology/article-abstract/2771173
  8. 8.0 8.1 8.2 8.3 8.4 NEJM Knowledge+ Ophthalmology

Patient information

optic neuritis patient information