Pain in Optic Perineuritis: Author Response

Coppens, Stefan; Petzold, Axel; Vries–Knoppert, Willemien A. E. J. de

doi:10.3109/01658107.2015.1004589

Cited by 2 publications

(2 citation statements)

References 8 publications

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“…The optic nerve does not contain pain receptors. However, patients with retrobulbar optic neuritis (ON) may experience pain with eye movement on account of traction on the optic nerve sheath stimulating nociceptive afferents of trigeminal origin where the sheath adheres to the superior and medial recti at the orbital apex [1]. Pain often precedes vision change, and is characteristic of Multiple Sclerosis (MS)-associated ON, and ON associated with antimyelin oligodendrocyte glycoprotein antibodies (MOG-ON) and anti-aquaportin-4 antibodies (AQP4-ON).…”

Section: How Do I Spot An Acute Optic Neuritis?mentioning

confidence: 99%

How far should I manage acute optic neuritis as an ophthalmologist? A United Kingdom perspective

Laviers,

Petzold,

Braithwaite

2024

Eye

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Optic neuritis (ON) is an inflammation of or around the optic nerve, frequently caused by infectious or immune-mediated inflammatory disorders. In the UK, its strongest association is with Multiple Sclerosis (MS), though the combined prevalence of other associated infectious and immune-mediated inflammatory diseases (I-IMID) is similar to that of MS-ON. Prompt identification and understanding of ON’s underlying cause informs tailored management and prognosis. Several IMIDs linked to ON, such as aquaporin-4 antibody-associated optic neuritis (AQP4-ON), myelin oligodendrocyte glycoprotein antibody-associated optic neuritis (MOG-ON), and neuro-sarcoidosis, show remarkable response to corticosteroid treatment. Therefore, urgent investigation and treatment are crucial in cases ‘atypical’ for MS-ON. Following the 1992 Optic Neuritis Treatment Trial, clinical practice has evolved, with short-course high-dose corticosteroids considered safe and effective for most people. Timely recognition of patients who could benefit is critical to avoid irreversible vision loss. This review provides a practical guide and a summary of evidence on the investigation and management of acute optic neuritis. It reflects the knowledge and limitations of current evidence, framed through the neuro-ophthalmic perspective of clinical practice at multiple UK academic centres.

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Section: How Do I Spot An Acute Optic Neuritis?mentioning

confidence: 99%

How far should I manage acute optic neuritis as an ophthalmologist? A United Kingdom perspective

Laviers,

Petzold,

Braithwaite

2024

Eye

Self Cite

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“…Dyschromatopsia, visual field abnormalities, and RAPD can all be present [69]. Pain is a prominent feature, as the optic nerve sheath contains pain fibers of trigeminal origin [70]. OPN may be a primary syndrome with no apparent underlying cause (idiopathic OPN), or it may part of an identifiable systemic disorder (secondary OPN) [63].…”

Section: Primary Idiopathic Optic Perineuritismentioning

confidence: 99%

Beyond Myelin Oligodendrocyte Glycoprotein and Aquaporin-4 Antibodies: Alternative Causes of Optic Neuritis

Greco,

Colombo,

Gastaldi

et al. 2023

IJMS

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Optic neuritis (ON) is the most common cause of vision loss in young adults. It manifests as acute or subacute vision loss, often accompanied by retrobulbar discomfort or pain during eye movements. Typical ON is associated with Multiple Sclerosis (MS) and is generally mild and steroid-responsive. Atypical forms are characterized by unusual features, such as prominent optic disc edema, poor treatment response, and bilateral involvement, and they are often associated with autoantibodies against aquaporin-4 (AQP4) or Myelin Oligodendrocyte Glycoprotein (MOG). However, in some cases, AQP4 and MOG antibodies will return as negative, plunging the clinician into a diagnostic conundrum. AQP4- and MOG-seronegative ON warrants a broad differential diagnosis, including autoantibody-associated, granulomatous, and systemic disorders. These rare forms need to be identified promptly, as their management and prognosis are greatly different. The aim of this review is to describe the possible rarer etiologies of non-MS-related and AQP4- and MOG-IgG-seronegative inflammatory ON and discuss their diagnoses and treatments.

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Pain in Optic Perineuritis: Author Response

Cited by 2 publications

References 8 publications

How far should I manage acute optic neuritis as an ophthalmologist? A United Kingdom perspective

How far should I manage acute optic neuritis as an ophthalmologist? A United Kingdom perspective

Beyond Myelin Oligodendrocyte Glycoprotein and Aquaporin-4 Antibodies: Alternative Causes of Optic Neuritis

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