Optic Neuritis Flashcards
what is optic neuritis
an inflammatory, demyelinating condition that causes acute, usually monocular, vision loss
what is optic neuritis associated with
multiple sclerosis
what is the epidemiology of optic neuritis
caucasian women in child-bearing years
higher latitudes
what is the pathophysiology of optic neuritis
inflammatory demyelination of the optic nerve
- similar to MS plaques in the brain
- immune-mediated
what are the clinical features of acute optic neuritis
usually painful, monocular vision loss
- worsened with eye movement
- central visual acuity (central scotoma)
- loss of color vision out of proportion to visual acuity loss
photopsias = flickering or flashes of light
- precipitated with eye movement
relevant afferent pupillary defect
what are the clinical features of chronic optic neuritis
persistent visual loss
- most recover function within 1yr
- deficits in color vision, contrast sensitivity, stereo acuity, and light brightness
- relative afferent pupillary defect
- color desaturation
- optic atrophy
- delayed pattern shift visual evoked response (VER)
how is optic neuritis diagnosed
clinically
- ophthalmologic essential feature
MRI of brain with gadolinium
what is the prognosis of optic neuritis
recovery of vision within a few weeks without treatment
what are the less favorable prognostic indicators of optic neuritis
lower visual acuity at presentation longer lesions African Americans children MS dx
what is the risk of MS in optic neuritis
5yr incidence = 30%
- median time to dx = 3yrs
15yr incidence = 50%
what is the treatment focus of optic neuritis
improving vision and preventing or ameliorating development of MS
what is the treatment of acute optic neuritis
high dose IV methylprednisolone x3d
- may delay onset of MS and hasten visual recovery
what is an alternative therapy in acute optic neuritis
IVIG and plasma exchange
disease-modifying therapy
