-2 :: Case - 6655 :: - optic neuritis
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Additional Discussion:
For this particular patient, his male gender, the fact that the MRI of the brain yielded no other lesions typical for MS, and the bilateral nature of the optic neuritis, all suggest ADEM (or Devic Disease, NMO) as possible etiology for his disease.

Discussion Author: Pil Kang

Optic neuritis is an acute inflammatory optic neuropathy. It is the most common type of optic neuropathy which causes acute visual loss in young to middle-aged adults. Usual symptoms are acute reduction of visual acuity, pain (especially with eye movements), and papilledema. (1)

In a ten-year study of 388 patients who experienced acute optic neuritis, it was noted that the ten-year risk of developing multiple sclerosis was 38%. Patients who had one or more typical lesions for MS on the MRI of the brain had 56% risk, and those without such lesions had 22% risk. Among the patients with no typical MS lesions on the MRI of the brain, male gender, optic disc swelling, perpapillary hemorrhages, and retinal exudates were associated with a lower risk of developing MS. (2)

Another major cause of optic neuritis is acute disseminated encephalomyelitis (ADEM). ADEM is a post-infectious inflammatory process, mediated by auto-reactive immune cells or antibodies. It has been noted that bilateral optic neuritis and transverse myelitis are particularly suggestive of ADEM. (3)

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