Acute Optic Neuritis: An Update on Approach and Management

Sepideh Jamali Dogahe, Parastou Pakravan, Mohammad Pakravan

Research output: Contribution to journalReview articlepeer-review


This review discusses the physical examination and diagnostic tests necessary to diagnose optic neuritis (ON) and provides an update on the approach and management of acute ON. A comprehensive search of the PubMed database was conducted, limited to English-language journals and recent publications. A total of 160 articles were initially screened by title, of which 73 articles were included in the narrative synthesis. ON is an inflammation of the optic nerve that can be caused by different systemic and neurological disorders. It is commonly presented as a subacute unilateral painful vision loss, and based on its clinical manifestation, it can be classified as typical or atypical. Atypical ON is bilateral with visual acuity of worse than 20/200 or has an atypical demographic presentation for demyelination, such as a non-Caucasian male with optic disc swelling, for which neuromyelitis optica spectrum disorder (NMOSD), myelin-oligodendrocyte glycoprotein antibody-associated disease (MOGAD), or other etiologies should be considered. Steroids and immunosuppressants are the main treatment options for ON, and timely treatment initiation is critical to preventing irreversible vision loss, especially in atypical cases.

Original languageEnglish (US)
Pages (from-to)433-440
Number of pages8
JournalJournal of Ophthalmic and Vision Research
Issue number4
StatePublished - Oct 2023


  • MOG
  • Neuromyelitis optica
  • Optic neuritis

ASJC Scopus subject areas

  • Ophthalmology


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