Optic Neuritis
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Basics
Description
- Optic nerve dysfunction due to an inflammatory process, commonly associated with myelin destruction, leading to acute vision loss
- Highly associated with multiple sclerosis (MS); presenting feature in 15–20% of MS patients
- Grouped by site of inflammation:
- Papillitis: Inflammation of the optic disk
- Retrobulbar neuritis: Inflammation of the optic nerve proximal to the globe
- 5 yr risk for clinically definite MS following optic neuritis:
- Normal MRI – 16%
- >3 lesions on MRI – 51%
- Recurrence is seen in 35% of patients
Etiology
- Idiopathic:
- Most common
- Single isolated events
- MS:
- 20–50% of patients with optic neuritis
- Likely genetic component
- High prevalence of A23, B7, and DR2 HLA alleles in patients with optic neuritis
- Viral infections:
- Chicken pox
- Measles
- Mononucleosis
- HSV and HZV
- Encephalitis
- Postviral optic neuritis:
- Usually occurs 4–6 wk after a nonspecific viral illness
- Granulomatous inflammation:
- TB
- Syphilis
- Sarcoidosis
- Cryptococcal infection
- SLE
- HIV:
- Cytomegalovirus
- Toxoplasmosis
- Histoplasmosis
- Cryptococcus
- Lyme disease
- Contiguous inflammation of meninges, orbit, sinuses, and intraocular inflammation
- Drug induced:
- Amiodarone
- Ethambutol
- Tamoxifen
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Basics
Description
- Optic nerve dysfunction due to an inflammatory process, commonly associated with myelin destruction, leading to acute vision loss
- Highly associated with multiple sclerosis (MS); presenting feature in 15–20% of MS patients
- Grouped by site of inflammation:
- Papillitis: Inflammation of the optic disk
- Retrobulbar neuritis: Inflammation of the optic nerve proximal to the globe
- 5 yr risk for clinically definite MS following optic neuritis:
- Normal MRI – 16%
- >3 lesions on MRI – 51%
- Recurrence is seen in 35% of patients
Etiology
- Idiopathic:
- Most common
- Single isolated events
- MS:
- 20–50% of patients with optic neuritis
- Likely genetic component
- High prevalence of A23, B7, and DR2 HLA alleles in patients with optic neuritis
- Viral infections:
- Chicken pox
- Measles
- Mononucleosis
- HSV and HZV
- Encephalitis
- Postviral optic neuritis:
- Usually occurs 4–6 wk after a nonspecific viral illness
- Granulomatous inflammation:
- TB
- Syphilis
- Sarcoidosis
- Cryptococcal infection
- SLE
- HIV:
- Cytomegalovirus
- Toxoplasmosis
- Histoplasmosis
- Cryptococcus
- Lyme disease
- Contiguous inflammation of meninges, orbit, sinuses, and intraocular inflammation
- Drug induced:
- Amiodarone
- Ethambutol
- Tamoxifen
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