Biomarker Defined Acute Optic Neuritis: A Review and Perspective

AbstractPurpose of reviewThis review provides a comprehensive summary of treatment options and management considerations for patients with acute inflammatory optic neuritis. A critical appraisal of the findings from landmark trials to the more recent studies is presented to provide a reference for diagnostic approaches, treatment options, and future research perspectives.Recent findingsThe Optic Neuritis Treatment Trial (ONTT) provides the best natural history study of optic neuritis and its relationship to remitting relapsing multiple sclerosis. In addition, the ONTT produced some unexpected and controversial results about corticosteroid therapy for optic neuritis. More recent studies have added new data about the duration of initial treatment, route of treatment (i.e. intravenous vs. oral bioequivalent), and inclusion of an oral tapering regimen. Although “optic neuritis” was synonymous with relapsing–remitting multiple sclerosis (RRMS) or a “clinically isolated syndrome” during the decade of the ONTT, recent discoveries about the neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated diso rder (MOGAD) have added biomarker-specific diagnostic diversity to the spectrum of optic neuritis, especially for those events previously labeled as “atypical.” Recognition of the different pathophysiological pathways for the phenotype of optic neuritis has led to new treatment approaches, parti cularly with plasmapheresis,...
Source: Current Treatment Options in Neurology - Category: Neurology Source Type: research