What is optic neuritis?
Optic neuritis is a condition that is due to inflammation of the optic nerve (nerve of the eye) present especially in women between the ages of 20 and 40.
Why does optic neuritis occur?
The most common cause of optic neuritis is represented by the inflammatory demyelination of the optic nerve, the destruction of myelin (a compound that wraps around axons and accelerates the transmission of nerve impulses) being due to an autoimmune process (the immune system destroys the body’s own tissues), of an infectious type (viral encephalitis, meningitis, sinusitis, tuberculosis, HIV infection) or tumor (metastatic tumors of the optic nerve).
Patients with optic neuritis frequently present other demyelinations in the nervous system that cause multiple sclerosis, an autoimmune disease characterized by myelin destruction in different regions of the brain and spinal cord.
Less common causes of optic neuritis in medical practice are diabetes, Graves’ disease, craniocerebral trauma or insect bites.
What are the symptoms of optic neuritis?
Optic neuritis is a condition that causes a decrease in visual acuity (loss of single or binocular vision) in the form of blurred vision, total or partial loss of central vision, decreased ability to perceive colors or reduced vision at night or in low light conditions. The pain associated with optic neuritis is triggered by mobilizing the eye and can be accompanied by intermittent light flashes, with some people complaining of blurred vision under conditions of effort.
Diagnosis of optic neuritis
The diagnosis of optic neuritis is established by the ophthalmologist based on the patient’s history and clinical consultation. Additional imaging investigations such as nuclear magnetic resonance with contrast material confirm the presence of demyelination both in the optic nerve and in other areas of the central nervous system. Optical coherence tomography or OCT examination allows obtaining detailed 3D images of the eye, its blood vessels and the degenerative changes of the optic nerve specific to neuromyelitis Optica.
The test of visually evoked potentials involves the quantification of the electrical energy conducted at the level of the eye and involves the use of electrodes that monitor brain activity while the patient is asked to follow a moving object with his eyes.
Optical coherence tomography is a non-invasive method of diagnosing optic neuritis by which the thickness of the optic nerve fibers is determined.
Lumbar puncture is an invasive method of differential diagnosis of optic neuritis with multiple sclerosis or bilateral optic neuritis of infectious cause.
Laboratory investigations are used to determine various diseases that can be complicated by the appearance of optic neuritis: Lyme disease, Lupus erythematosus, syphilis, sarcoidosis, and temporal arteritis.
Treatment in optic neuritis
The treatment of optic neuritis is etiological and addresses the cause that induced its appearance, in certain situations the inflammation of the optic nerve is reduced after parenteral administration of corticoids.
Find out more:
- Optic neuritis – https://www.sciencedirect.com/science/article/abs/pii/S147444221370259X
- Optic neuritis – https://www.nejm.org/doi/full/10.1056/NEJMcp053247
- The Clinical Profile of Optic Neuritis: Experience of the Optic Neuritis Treatment Trial – https://mayoclinic.pure.elsevier.com/en/publications/the-clinical-profile-of-optic-neuritis-experince-of-the-optic-us
