Acute-Onset Retinal Conditions Mimicking Acute Optic Neuritis: Overview and Differential Diagnosis

Abstract

Acute optic neuritis (AON) is a common cause of sudden visual loss in young patients. Because of the risk of demyelinating disease, patients affected by unilateral or bilateral optic neuritis should be evaluated and treated accordingly. Despite advancements in imaging of the brain and retina, misdiagnosis of AON is not uncommon. Indeed, some acute disorders of the retina have the potential to mimic AON and their prompt diagnosis may avoid unnecessary neurologic investigation, psychological stress to the patient, and delays in treatment. This review describes uncommon retinal disorders presenting with sudden-onset visual loss and absent or subtle funduscopic manifestation that can mimic AON. Multimodal retinal imaging is essential in detecting these conditions and in their differential diagnosis. It behooves neurologists and general ophthalmologists to be aware of these entities and be familiar with multimodal imaging of the retina.

Hyperreflective Dots in Central Fovea Visualized by a Novel Application of Visible‐Light Optical Coherence Tomography

“…In addition, we averaged five B-scans along the x -axis and plotted an 11-pixel-thick (~15 μ m) arc to produce a speckle-reduced B-scan at selected locations across the foveal region [ 6 ]. Note that the generation of a NIR-OCT fibergram is not possible because (1) the Spectralis OCT dataset only provides limited B-scans/volume (~19 B-scans/volume) [ 12 ] which is not sufficient to recreate a fibergram en face image and (2) the NIR-OCT axial resolution is not high enough to accurately resolve individual axon bundles [ 13 ].…”

An overview of neuro-ophthalmic disorders at Jenna Ophthalmic Center, Baghdad, Iraq (2021-2022)

“…Changes in the sensory and motor pathways may arise from many circumstances, such as autoimmune disorders, infectious, inflammation, ischemic, traumatizing, compressive, inherited, or degenerative diseases [ 16 ]. It is not uncommon for a neuro-ophthalmic dysfunction, such as inflammatory optic neuropathy, to serve as an early indication of an underlying neurological disorder, such as multiple sclerosis [ 17 ]. Similarly, the optic nerve head (ONH) swelling may serve as the only indication of heightened intracranial pressure resulting from critical brain diseases that need immediate medical attention [ 18 , 19 ].…”