Optic Neuritis

2019 ◽  
pp. 3-8
Author(s):  
Matthew J. Thurtell ◽  
Robert L. Tomsak

Optic neuritis is the most frequent cause of acute-onset optic neuropathy in young adults and is often encountered in clinical practice. In this chapter, we begin by reviewing the cardinal signs of optic neuropathy. We review the clinical characteristics and workup of optic neuritis. We review factors that increase the risk for developing multiple sclerosis. We discuss atypical clinical and imaging findings that should prompt further evaluation for other causes of optic neuritis, such as neuromyelitis optica. Lastly, we discuss the management options for optic neuritis, with reference to the findings from the Optic Neuritis Treatment Trial, and the prognosis for visual recovery.

2020 ◽  
Vol 8 (2) ◽  
pp. 73-79
Author(s):  
Okta Della Susmitha ◽  
Muhammad Yusran

Pendahulan: Neuritis Optik (ON) didefinisikan sebagai inflamasi pada saraf optik, yang sebagian besar idiopatik. Namun dapat dikaitkan dengan penyebab lain seperti lesi demielinasi, gangguan autoimun, infeksi dan inflamasi. Dari semua ini, multiple sclerosis (MS) adalah penyebab paling umum dari demielinasi ON. Tujuan: Untuk mengetahui diagnosis dan tatalaksana neuritis optik demielinasi. Metode: Artikel ini dibuat dengan metode literature review, melibatkan 29 pustaka baik buku dan jurnal nasional atau internasional. Hasil: ON terjadi karena proses inflamasi yang mengarah pada aktivasi sel-T yang dapat melewati sawar darah otak dan menyebabkan reaksi hipersensitivitas terhadap struktur saraf. Mekanisme pastinya belum diketahui. Diagnosis klinis ON terdiri dari tiga gejala klasik yaitu kehilangan penglihatan, nyeri periokular dan dischromatopsia. Hal ini membutuhkan pemeriksaan oftalmik, neurologis dan sistemik yang cermat untuk membedakan antara ON spesifik dan tidak. Diagnosis banding diperlukan untuk membuat rencana tatalaksana yang tepat. Pembahasan: Menurut Optic Neuritis Treatment Trial (ONTT), pengobatan pertama adalah metilprednisolon intravena dengan pemulihan yang lebih cepat dan lebih sedikit kemungkinan kasus relaps dan konversi ke MS. Namun prednisolon oral saja dikontraindikasikan karena peningkatan risiko relaps. Controlled High-Risk Subjects Avonex® Multiple Sclerosis Prevention Study (CHAMPS) dan Early Treatment of MS study (ETOMS) dan telah melaporkan bahwa pengobatan dengan interferon β-1a, dengan hasil pengurangan risiko karakteristik MS dari MRI. Sensitivitas kontras, penglihatan warna dan bidang visual adalah parameter yang sebagian besar tetap terganggu bahkan setelah pemulihan ketajaman visual yang baik. Simpulan: Tatalaksana pada neuritis optik demielinasi dominan diberikan steroid dan interferon β-1a.   Kata kunci: demielinasi, multipel skeloris, neuritis optik, tatalaksana  


2022 ◽  
Vol 7 (4) ◽  
pp. 728-730
Author(s):  
I D Chaurasia ◽  
Yogita Chaurasia

To evaluate the visual and neurological outcomes of Optic Neuritis Treatment Trial (ONTT). 40 Patients presenting with optic neuritis were enrolled in this study to analyze the Visual and Neurological outcomes after treatment according to ONTT Protocol, with emphasis on signs of anaemia, protein calorie malnutrition, vitamin deficiency, generalized lymphadenopathy, sinusitis, septic foci. Patients were followed up for three subsequent visits to assess the rate of visual recovery.Maximum patient 35(87.5) treated according to ONTT protocol while 5 (12.5%) treated with oral steroids alone. Maximum 33 eyes (70.2%) attain BCVA > 6/36 after 1st follow-up (with in 1 month) while 10(21.3%) eyes attain BCVA of 6/6 after 1st follow-up. 11 eyes (25.6%) attain BCVA 6/6 after II follow-up. General prognosis for recovery of vision was good and was slightly worse in more severely affected cases in the present series. Pallor of the optic disc and defect of vision did not always correspond–3 eyes which showed temporal of the disc at the end of follow up had a final vision of 6/9 or better in each eye.


1970 ◽  
Vol 12 (4) ◽  
pp. 216-217
Author(s):  
James F. Cullen

This review evaluates a number of recent studies on optic neuritis carried out in Singapore. In Singapore, and probably throughout Asia, the disease is more likely to be of the anterior variety with optic disc swelling, and is sometimes associated with an underlying infective process such as syphilis or tuberculosis, or is of an autoimmune aetiology. Most cases of optic neuritis seen in Singapore are idiopathic; multiple sclerosis is rarely seen in the region, but is likely to be found only in patients with retrobulbar optic neuritis. The 4-year risk for patients in Singapore developing multiple sclerosis is only 9.1% compared with the higher figures reported from the seminal Optic Neuritis Treatment Trial. The usefulness of magnetic resonance imaging in the management of optic neuritis in Singapore is reported.


2020 ◽  
Vol 6 (2) ◽  
pp. 74-77
Author(s):  
Mohammad Enayet Hussain ◽  
Bithi Debnath ◽  
AFM Al Masum Khan ◽  
Md Ferdous Mian ◽  
Md Nahidul Islam ◽  
...  

Background: The visual evoked potentials (VEP) is a valuable tool to document occult lesions of the central visual channels especially within the optic nerve. Objectives: The purpose of the present study was to observe the findings of first few cases of VEP done in the neurophysiology department of the National Institute of Neurosciences (NINS), Dhaka, Bangladesh. Methodology: This cross-sectional study was conducted in the Department of Neurophysiology at the National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from September 2017 to March 2020. All patients referred to the Neurophysiology Department of NINS for VEP were included. Pattern reversal VEPs were done using standard protocol set by International Federation of Clinical Neurophysiology (IFCN). Results: The mean age of the study population was 30.70 (±12.11) years (6-68 years) with 31 (46.3%) male and 36 (53.7%) female patients. The mean duration of illness was 8.71 (±1.78) months (3 days- 120 months). Most common presenting symptom was blurring of vision (37.3%) and dimness of vision (32.8%). Patterned VEP revealed mixed type (both demyelinating and axonal) of abnormality in most cases [29(43.35)]. The most common clinical diagnosis was multiple sclerosis (29.85%) and optic neuropathy (26.87%). In the clinically suspected cases of multiple sclerosis, optic neuropathy and optic neuritis most of the cases of VEP were abnormal and the p value is 0.04 in optic neuropathy and optic neuritis. Conclusion: The commonest presentation of the patients in this series were blurring of vision and dimness of vision. The most common clinical diagnosis for which VEP was asked for, was optic neuritis and multiple sclerosis. Most abnormalities were of mixed pattern (demyelinating and axonal). Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 74-77


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