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The repetition of an idiopathic optic neuritis is considered a distinct clinical condition, and when it shows demyelination, it has been found to be associated to anti-MOG and AQP4-negative neuromyelitis optica. [20] When an inflammatory recurrent optic neuritis is not demyelinating, it is called chronic relapsing inflammatory optic neuropathy ...
Corticosteroid responsive optic neuritis not associated with demyelinating disease should also be ruled out, including sarcoidosis, systemic lupus erythematosus, or other systemic autoimmune disease. [11] Hereditary causes such as Leber's hereditary optic neuropathy are also part of the differential diagnosis. [12]
multiple sclerosis associated optic neuritis (MSON) unclassified optic neuritis (UCON) forms. [4] Medical examination of the optic nerve with an ophthalmoscope may reveal a swollen optic nerve, but the nerve may also appear normal. Presence of an afferent pupillary defect, decreased color vision, and visual field loss (often central) are ...
RNFL asymmetry has been proposed as a strong indicator of optic neuritis, [7] [8] with one small study proposing that asymmetry of 5–6μm was "a robust structural threshold for identifying the presence of a unilateral optic nerve lesion in MS." [9] Optic neuritis is often associated with multiple sclerosis, and RNFL data may indicate the pace ...
When the optic nerve is damaged, the sensory (afferent) stimulus sent to the midbrain is reduced. The pupil, responding less vigorously, dilates from its prior constricted state when the light is moved away from the unaffected eye and towards the affected eye. This response is a relative afferent pupillary defect (or Marcus Gunn pupil). [1]
Optic neuritis: Either 1) brain MRI showing normal findings or only nonspecific white matter lesions, or 2) optic nerve MRI showing T2-hyperintensity, or T1 enhancing lesion, greater than 1/2 optic nerve length or involving optic chiasm Acute myelitis: intramedullary lesion > 3 contiguous segments, or spinal atrophy ≥ 3 contiguous segments
Autoimmune optic neuropathy (AON), sometimes called autoimmune optic neuritis, may be a forme fruste of systemic lupus erythematosus (SLE) associated optic neuropathy. AON is more than the presence of any optic neuritis in a patient with an autoimmune process, as it describes a relatively specific clinical syndrome.
The exact mechanism of optic nerve ischemia in these cases remains unclear, but contributing factors may include hypotension, anemia, hypoxia, and changes in the autoregulation of optic nerve arterial blood flow. The incidence of ischemic optic neuropathy leading to vision loss following general surgeries ranges between 0.1% and 0.002%. [15] [16]