Diagnosis and classification of optic neuritis

Petzold, Axel; Fraser, Clare; Abegg, Mathias; Alroughani, Raed; Alshowaeir, Daniah; Alvarenga, Regina Maria Papais; Andris, Cécile; Asgari, Nasrin; Barnett, Yael; Battistella, Roberto; Behbehani, Raed; Berger, Thomas; Бикбов, М.М.; Biotti, Damien; Biousse, Valérie; Boschi, Antonella; Brazdil, Milan; Brezhnev, Andrei; Calabresi, Peter A.; Cordonnier, Monique; Costello, Fiona; Cruz, Franz Marie; Cunha, Leonardo Provetti; Daoudi, Smail; Deschamps, Romain; Sèze, Jérôme De; Diem, Ricarda; Etemadifar, Masoud; Flores-Rivera, José; Fonseca, Pedro; Frederiksen, Jette; Frohman, Elliot M.; Frohman, Teresa C.; Tilikete, Caroline; Fujihara, Kazuo; Gálvez, Alberto; Gouider, Riadh; Gracia, Fernando; Grigoriadis, Nikolaos; Guajardo, J.; Habek, Mario; Hawlina, Marko; Martínez-Lapiscina, Elena H.; Hooker, Juzar; Hor, Jyh Yung; Howlett, William; Huang‐Link, Yumin; Idrissova, Zhannat; Illés, Zsolt; Jančić, Jasna; Jindahra, Panitha; Karussis, Dimitrios; Kerty, Emı́lia; Kim, Ho Jin; Lagrèze, Wolf A.; Leocani, Letizia; Levin, Netta; Lišková, Petra; Liu, Yaou; Maiga, Youssoufa; Marignier, Romain; McGuigan, Chris; Meira, Dália; Merle, H.; Monteiro, Mário Luiz Ribeiro; Moodley, Anand; Moura, Frederico Castelo; Muñoz, Silvia; Mustafa, Sharik; Nakashima, Ichiro; Noval, Susana; Oehninger, Carlos; Ogun, Olufunmilola; Omoti, Afekhide; Pandit, Lekha; Paul, Friedemann; Rebolleda, Gema; Reddel, Stephen W.; Rejdak, Konrad; Ręjdak, Robert; Rodríguez‐Morales, Alfonso J.; Rougier, Marie-Bénédicte; José, María; Sánchez-Dalmau, Bernardo; Saylor, Deanna; Shatriah, Ismail; Síva, Aksel; Stiebel‐Kalish, Hadas; Szatmáry, Gabriella; Ta, Linh; Tenembaum, Sílvia; Tran, Huy; Trufanov, Yevgen; Pesch, Vincent Van; Wang, An-Guor; Wattjes, Mike P.; Willoughby, Ernest; Zakaria, Magd; Zvornicanin, Jasmin; Balcer, Laura J.; Plant, Gordon T.

doi:10.1016/s1474-4422(22)00200-9

Cited by 113 publications

(96 citation statements)

References 159 publications

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“…Furthermore, the symptoms of ON and GBS occurred simultaneously or sequentially in a short time, and most patients had a history of antecedent infections without pleocytosis in the CSF, suggesting a post-infectious immune-mediated etiology in most cases. Notably, our patient presented with bilateral and severe visual loss, monophasic course, and no detection of antibodies related to CNS demyelinating diseases, consistent with the characteristics of most published cases with concurrent ON and GBS and other post-infectious ON [ 13 , 14 ].…”

Section: Discussionsupporting

confidence: 87%

Co-occurrence of polyneuritis crainials and visual impairment: a case report and literature review

Huang

et al. 2022

Neurol Sci

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Background Polyneuritis cranialis (PNC) with the disease characteristics of Guillain-Barré syndrome (GBS) in addition to both ocular and bulbar weakness in the absence of limb paralysis or ataxia is defined as an unusual variant of GBS. As evidence of central nervous system (CNS) involvement, visual impairment is an unusual finding complicating with GBS spectrum disorders and has never been reported in patients with PNC. Methods We describe a very rare case who clinically presented with progressive multiple cranial nerve palsy and visual impairment. Furthermore, a literature search of concurrent GBS and optic neuritis (ON) as well as PNC attributed to GBS was conducted. Results A diagnosis of PNC was considered due to the typical clinical characteristics as well as the presence of cerebrospinal fluid cytoalbumin dissociation and serum antibodies against gangliosides. The clinical manifestations and the bilateral optic nerve involvement in brain magnetic resonance imaging further suggested possible optic neuritis (ON). The patient received treatment with intravenous immunoglobulin followed by short-term use of corticosteroids and finally achieved a full recovery. Thirty-two previously reported cases (17 women, mean age 40) of concurrent GBS and ON and 20 cases of PNC (5 women, mean age 40) were analyzed. We further provided a comprehensive discussion on the potential etiologies, clinical features, therapeutic strategies, and prognosis. Conclusions This rare case with the co-occurrence of PNC and visual impairment and the related literature review may help clinicians advance the understanding of GBS spectrum disorders and make appropriate diagnoses and treatment decisions for the rare variants and CNS complications of GBS. Supplementary Information The online version contains supplementary material available at 10.1007/s10072-022-06580-0.

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Section: Discussionsupporting

confidence: 87%

Co-occurrence of polyneuritis crainials and visual impairment: a case report and literature review

Huang

et al. 2022

Neurol Sci

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“…Case 1 presents atypical ON without eye pain nor dyschromatopsia, though there are risk factors for MS-associated ON (MS-ON) including age, sex and ethnic Caucasian background [ 8 , 13 , 21 ]. Hypertension and migraine together with a family history of heart disease mislead the diagnosis to amaurosis fugax/migraine with aura.…”

Section: Discussionmentioning

confidence: 99%

“…VEP showed normal latency of bilateral P100 at one year’s follow-up). Thus, bilateral subclinical ON was confirmed with MRI, OCT and VF [ 10 , 20 ] and MOG-associated disease diagnosis was fulfilled according to ON classification proposed by Petzold et al [ 13 ]. The patient was treated first with plasma exchanges five times, then with methylprednisolone 1 g/day for three days followed by rituximab twice per year.…”

Section: Methodsmentioning

confidence: 99%

“…Silent optic nerve atrophy and lesion have been identified in non-ON eyes in MS [ 10 , 12 ] by using imaging modalities indicating an omitted diagnosis of atypical or subclinical ON. Atypical ON at onset or subclinical ON during disease course is a challenge in diagnosis and lack of consensus, which may delay time to effective therapy [ 13 ]. In a recent position paper, OCT was proposed to be one of the three obligatory paraclinical methods to assist diagnosis of ON [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…Atypical ON at onset or subclinical ON during disease course is a challenge in diagnosis and lack of consensus, which may delay time to effective therapy [ 13 ]. In a recent position paper, OCT was proposed to be one of the three obligatory paraclinical methods to assist diagnosis of ON [ 13 ]. OCT as a high-resolution retinal imaging technique can quantify ten retinal layers including the retinal nerve fiber layer (RNFL) and the macular ganglion cell-inner plexiform layer (GCIPL) at the level of a few micrometers.…”

Section: Introductionmentioning

confidence: 99%

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The Importance of Optical Coherence Tomography in the Diagnosis of Atypical or Subclinical Optic Neuritis: A Case Series Study

Huang‐Link

Yang

Gustafsson

et al. 2023

JCM

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Background: Optic neuritis (ON) is an inflammatory condition of the optic nerve. ON is associated with development of demyelinating diseases of the central nervous system (CNS). CNS lesions visualized by magnetic resonance imaging (MRI) and the finding of oligoclonal IgG bands (OB) in the cerebrospinal fluid (CSF) are used to stratify the risk of MS after a “first” episode of ON. However, the diagnosis of ON in absence of typical clinical manifestations can be challenging. Methods and Materials: Here we present three cases with changes in the optic nerve and ganglion cell layer in the retina over the disease course. (1) A 34-year-old female with a history of migraine and hypertension had suspect amaurosis fugax (transient vision loss) in the right eye. This patient developed MS four years later. Optical coherence tomography (OCT) showed dynamic changes of the thickness of peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) over time. (2) A 29-year-old male with spastic hemiparesis and lesions in the spinal cord and brainstem. Six years later he showed bilateral subclinical ON identified using OCT, visual evoked potentials (VEP) and MRI. The patient fulfilled diagnosis criteria of seronegative neuromyelitis optica (NMO). (3) A 23-year-old female with overweight and headache had bilateral optic disc swelling. With OCT and lumbar puncture, idiopathic intracranial hypertension (IIH) was excluded. Further investigation showed positive antibody for myelin oligodendrocyte glycoprotein (MOG). Conclusions: These three cases illustrate the importance of using OCT to facilitate quick, objective and accurate diagnosis of atypical or subclinical ON, and thus proper therapy.

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Interactions of optic radiation lesions with retinal and brain atrophy in early multiple sclerosis

Lin,

Chien,

Kuchling

et al. 2023

Ann Clin Transl Neurol

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ObjectiveRetrograde trans‐synaptic neuroaxonal degeneration is considered a key pathological factor of subclinical retinal neuroaxonal damage in multiple sclerosis (MS). We aim to evaluate the longitudinal association of optic radiation (OR) lesion activity with retinal neuroaxonal damage and its role in correlations between retinal and brain atrophy in people with clinically isolated syndrome and early MS (pweMS).MethodsEighty‐five pweMS were retrospectively screened from a prospective cohort (Berlin CIS cohort). Participants underwent 3T magnetic resonance imaging (MRI) for OR lesion volume and brain atrophy measurements and optical coherence tomography (OCT) for retinal layer thickness measurements. All pweMS were followed with serial OCT and MRI over a median follow‐up of 2.9 (interquartile range: 2.6–3.4) years. Eyes with a history of optic neuritis prior to study enrollment were excluded. Linear mixed models were used to analyze the association of retinal layer thinning with changes in OR lesion volume and brain atrophy.ResultsMacular ganglion cell‐inner plexiform layer (GCIPL) thinning was more pronounced in pweMS with OR lesion volume increase during follow‐up compared to those without (Difference: −0.82 μm [95% CI:‐1.49 to −0.15], p = 0.018). Furthermore, GCIPL thinning correlated with both OR lesion volume increase (β [95% CI] = −0.27 [−0.50 to −0.03], p = 0.028) and brain atrophy (β [95% CI] = 0.47 [0.25 to 0.70], p < 0.001). Correlations of GCIPL changes with brain atrophy did not differ between pweMS with or without OR lesion increase ( = 5.92e−7, p = 0.762).InterpretationFaster GCIPL thinning rate is associated with increased OR lesion load. Our results support the value of GCIPL as a sensitive biomarker reflecting both posterior visual pathway pathology and global brain neurodegeneration.

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Diagnosis and classification of optic neuritis

Cited by 113 publications

References 159 publications

Co-occurrence of polyneuritis crainials and visual impairment: a case report and literature review

Co-occurrence of polyneuritis crainials and visual impairment: a case report and literature review

The Importance of Optical Coherence Tomography in the Diagnosis of Atypical or Subclinical Optic Neuritis: A Case Series Study

Interactions of optic radiation lesions with retinal and brain atrophy in early multiple sclerosis

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