Optic neuritis: pathophysiology, clinical features, and diagnosis

Abstract

Background: Optic neuritis encompasses a group of disorders characterized by acute or subacute vision loss caused by optic nerve inflammation. The etiologies of optic neuritis are diverse, including demyelinating events, autoimmune disorders, granulomatous disease, and infections, each influencing prognosis and treatment. Current Concepts: Optic neuritis diagnosis involves comprehensive clinical evaluation, including history taking, physical examination, visual function tests, imaging studies, and serological as well as cerebrospinal fluid analyses, to determine the underlying cause and guide appropriate treatment. Optic neuritis associated with neuromyelitis optica spectrum disorder is characterized by severe demyelination and axonal damage, primarily affecting the optic nerve and the spinal cord through autoimmune mechanisms. It has been identified as a condition distinct from multiple sclerosis with the discovery of the neuromyelitis optica immunoglobulin G antibody. Myelin oligodendrocyte glycoprotein antibody is another specific biomarker that is gaining attention. Discussion and Conclusion: Optic neuritis is a complex condition with diverse causes and clinical manifestations, requiring a multifaceted diagnostic approach to tailor treatment strategies effectively and improve visual prognosis. New biomarkers are being discovered to redefine this disease.