Optic neuritis is a non-specific description of inflammation of the optic nerve and/or retina.
Common causes of optic neuritis:
> multiple sclerosis (and other demyelinating disease)
> sarcoidosis
> viral neuropathy
> lupus erythematosus (and other connective tissue disease)
Optic neuritis is a general term that is used to describe idiopathic or demyelinating optic neuropathy. Etiologies for optic neuritis include idiopathic (most common), demyelinating diseases (MS), infectious diseases (viral, syphilis, cat scratch disease, Lyme, etc), and inflammatory diseases (collagen vascular disease, sarcoid, etc). Unilateral, acute visual loss and pain that is worse with eye movement characterize typical optic neuritis. It usually affects young adults (mostly female), but may occur in any age group. Ophthalmic findings of optic neuritis include decreased visual acuity and/or visual field, relative afferent pupillary defect, absence of uveitis, and a normal (65%) or swollen (35%) optic nerve. It has a well-recognized association with MS. Diagnostic tests typically include MRI of the brain and orbits to look for demyelinating white matter disease, as well as a thorough laboratory evaluation in atypical cases directed by history and physical exam (e.g., syphilis serologic testing, ANA, CXR, LP, etc). Ninety percent of cases of optic neuritis improve to normal or near normal vision with or without treatment.
Reference(s): Beck RW, Trobe JD. The Optic Neuritis Treatment Group. What we have learned from the Optic Neuritis Treatment Trial. Ophthalmology 1995; 102: 1504-8.
Isaak BL, Liesegang TJ, Michet CJ. Ocular and systemic findings in relapsing polychondritis. Ophthalmology 1986; 93: 681-9.
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