Abstract
Optic neuritis (ON) is a primary inflammation of the optic nerve mainly associated to demyelination. This may be the first episode in a subject who will develop multiple sclerosis (MS) later.
The main clinical manifestations are progressive decrease in visual acuity over the course of few weeks, retroocular pain, contrast sensitivity loss and evidence of an afferent papillary defect. Generally has a good prognosis for recovery.
The brain MRI is essential to identify lesions suggestive of MS and the evoked potentials may play a role in the subjects with a questioned MS diagnosis. The CSF may show mild abnormalities and the presence of oligoclonal bands.
The treatment of choice for the acute episode is IV methylprednisolone followed by oral prednisolone and the chronic treatment for patients which a higher risk for developing MS is with interferons.
Finally, it is important to have in mind the diagnosis of NMO, mainly in patients with recurrent ON and MRI not suggestive of MS since the treatment and prognosis may be significantly different.
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