Diagnosis and classification of optic neuritis

Petzold A 1 , Fraser CL 2 , Abegg M 3 , Alroughani R 4 , Alshowaeir D 5 , Alvarenga R 6 Show all authors , Andris C 7 , Asgari N 8 , Barnett Y 9 , Battistella R 10 , Behbehani R 11 , Berger T 12 , Bikbov MM 13 , Biotti D 14 , Biousse V 15 , Boschi A 16 , Brazdil M 17 , Brezhnev A 18 , Calabresi PA 19 , Cordonnier M 20 , Costello F 21 , Cruz FM 22 , Cunha LP 23 , Daoudi S 24 , Deschamps R 25 , de Seze J 26 , Diem R 27 , Etemadifar M 28 , Flores-Rivera J 29 , Fonseca P 30 , Frederiksen J 31 , Frohman E 32 , Frohman T 32 , Tilikete CF 33 , Fujihara K 34 , Gálvez A 35 , Gouider R 36 , Gracia F 37 , Grigoriadis N 38 , Guajardo JM 39 , Habek M 40 , Hawlina M 41 , Martínez-Lapiscina EH 42 , Hooker J 43 , Hor JY 44 , Howlett W 45 , Huang-Link Y 46 , Idrissova Z 47 , Illes Z 48 , Jancic J 49 , Jindahra P 50 , Karussis D 51 , Kerty E 52 , Kim HJ 53 , Lagrèze W 54 , Leocani L 55 , Levin N 56 , Liskova P 57 , Liu Y 58 , Maiga Y 59 , Marignier R 60 , McGuigan C 61 , Meira D 62 , Merle H 63 , Monteiro MLR 64 , Moodley A 65 , Moura F 66 , Muñoz S 67 , Mustafa S 68 , Nakashima I 69 , Noval S 70 , Oehninger C 71 , Ogun O 72 , Omoti A 73 , Pandit L 74 , Paul F 75 , Rebolleda G 76 , Reddel S 77 , Rejdak K 78 , Rejdak R 79 , Rodriguez-Morales AJ 80 , Rougier MB 81 , Sa MJ 82 , Sanchez-Dalmau B 83 , Saylor D 84 , Shatriah I 85 , Siva A 86 , Stiebel-Kalish H 87 , Szatmary G 88 , Ta L 89 , Tenembaum S 90 , Tran H 91 , Trufanov Y 92 , van Pesch V 93 , Wang AG 94 , Wattjes MP 95 , Willoughby E 96 , Zakaria M 97 , Zvornicanin J 98 , Balcer L 99 , Plant GT 100

Affiliations 

  • 1 The National Hospital for Neurology and Neurosurgery, University College London, London, UK; Moorfields Eye Hospital, London, UK; Neuro-ophthalmology Expert Centre, Amsterdam University Medical Center, Amsterdam, Netherlands. Electronic address: a.petzold@ucl.ac.uk
  • 2 Department of Ophthalmology, University of Sydney, Sydney, NSW, Australia
  • 3 Department of Ophthalmology, University of Bern, Bern, Switzerland
  • 4 Division of Neurology, Department of Medicine, Al-Amiri Hospital, Kuwait City, Kuwait
  • 5 Department of Ophthalmology, King Saud University, Riyadh, Saudi Arabia
  • 6 Department of Neurology, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
  • 7 Department of Ophthalmology, University Hospital Liege, University of Liège, Liège, Belgium
  • 8 Department of Neurology, Slagelse and Institute of Regional Health Research, and Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
  • 9 Department of Neuroradiology, St Vincent's Hospital, Sydney, NSW, Australia
  • 10 Department of Neuro-Ophthalmology, University of São Paulo, São Paulo, Brazil
  • 11 Neuro-Ophthalmology Unit, Ibn Sina Hospital, Kuwait City, Kuwait
  • 12 Department of Neurology, Medical University of Vienna, Vienna, Austria
  • 13 Ufa Eye Research Institute, Ufa, Russia
  • 14 Unité de Neurologie Inflammatoire B4, CHU Pierre-Paul Riquet/Purpan, Toulouse, France
  • 15 Neuro-Ophthalmology Unit, Emory Eye Center, Emory University, Atlanta, GA, USA
  • 16 Department of Head and Neck, Université Catholique de Louvain, Brussels, Belgium; Department of Ophthalmology, Cliniques Universitaires Saint Luc, Brusseles, Belgium
  • 17 Department of Neurology, Masaryk University, Brno, Czech Republic; St Anne's University Hospital, Brno, Czech Republic
  • 18 Department of Ophthalmology, Kursk State Medical University, Kursk, Russia
  • 19 The Solomon H Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
  • 20 Department of Ophthalmology, Université Libre de Bruxelles, Bruxelles, Belgium
  • 21 Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
  • 22 College of Medicine, University of the Philippines-Philippine General Hospital, Manila, Philippines
  • 23 Surgery Department of Juiz de Fora Medical School, Federal University of Juiz de Fora, Juiz de Fora, Brazil
  • 24 Department of Neurology, University Mouloud Mammeri de Ttizi Ouzou, Ttizi Ouzou, Algeria
  • 25 Department of Neurology, Hospital Foundation Adolphe de Rothschild, Paris, France
  • 26 Department of Neurology, Hopitaux Universitaires Strasbourg, Strasbourg, France
  • 27 Department of Neurology, University Clinic Heidelberg, Heidelberg, Germany
  • 28 Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran
  • 29 Universidad Nacional Autónoma de México, Instituto Nacional de Neurología y Neurocirugía, Centro Médico ABC, Mexico City, Mexico
  • 30 Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
  • 31 Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Neurology, Copenhagen University Hospital, Copenhagen, Denmark
  • 32 Department of Neurology, Laboratory of Neuroimmunology, Stanford University School of Medicine, Palo Alto, CA, USA
  • 33 Lyon Neurosciences Research Center, Lyon I University, Lyon France; Neuro-Ophthalmology Unit, Hospices Civils de Lyon, Lyon, France
  • 34 Department of Multiple Sclerosis Therapeutics, Fukushima Medical University School of Medicine, Koriyama, Japan
  • 35 Department of Ophthalmology, University of Alberta, AB, Canada
  • 36 Department of Neurology, Razi University Hospital, University of Tunis El Manar, Tunis, Tunisia
  • 37 Department of Neurology, Hospital Santo Tomás, Panama City, Panama; Instituto Conmemorativo Gorgas de Estudios de la Salud, Universidad Interamericana de Panama, Panama City, Panama
  • 38 Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • 39 Servicio de Oftalmología, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
  • 40 Department of Neurology, University of Zagreb School of Medicine, Zagreb, Croatia; Department of Neurology, University Hospital Center Zagreb, Zagreb, Croatia
  • 41 Eye Hospital, University Medical Centre, Ljubljana, Slovenia
  • 42 Department of Neurology, Hospital Clinic of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
  • 43 Aga Khan University Hospital, Nairobi, Kenya
  • 44 Department of Neurology, Penang General Hospital, Penang, Malaysia
  • 45 Department of Neurology, Kilimanjaro Christian Medical Center (KCMC), Moshi, Tanzania
  • 46 Department of Neurology, Linköping University Hospital, Linköping, Sweden
  • 47 Department of Neurology, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
  • 48 Department of Neurology, Odense University Hospital, Odense, Denmark
  • 49 Clinic of Neurology and Psychiatry for Children and Youth, Faculty of Medicine University of Belgrade, Belgrade, Serbia
  • 50 Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • 51 Multiple Sclerosis Center, Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
  • 52 Department of Neurology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
  • 53 Department of Neurology, National Cancer Center, Goyang, South Korea
  • 54 Eye Center, Medical Center, Medical Faculty, University of Freiburg, Germany
  • 55 Vita-Salute San Raffaele University, Experimental Neurophysiology Unit, Institute of Experimental Neurology-INSPE, Scientific Institute San Raffaele, Milan, Italy
  • 56 Department of Neurology, Hadassah Medical Center and Faculty of Medicine, Hebrew University, Jerusalem, Israel
  • 57 Department of Paediatrics and Inherited Metabolic Disorders, and Department of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
  • 58 Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
  • 59 Department of Neurology, Gabriel Touré University Hospital, Bamako, Mali
  • 60 Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et NeuroInflammation, and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Bron, France
  • 61 School of Medicine, University College Dublin, Dublin, Ireland; Department of Neurology, St Vincent's University Hospital, Dublin, Ireland
  • 62 Centro Hospitalar de Vila Nova de Gaia/Espinho, Portugal
  • 63 Department of Ophthalmology, University Hospital of Martinique, Martinique, French West Indies, France
  • 64 Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil
  • 65 Department of Neurology, University of KwaZulu-Natal, Durban, South Africa
  • 66 Department of Neuro-Ophthalmology, Instituto Paulista Da Visão, Higienópolis, Brazil
  • 67 Department of Ophthalmology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
  • 68 Department of Neurology, Prime Healthcare Group, Dubai, United Arab Emirates
  • 69 Department of Neurology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
  • 70 Department of Ophthalmology, Hospital Universitario La Paz, Madrid, Spain
  • 71 Department of Neurology, School of Medicine UDELAR, Montevideo, Uruguay
  • 72 Department of Ophthalmology, College of Medicine, University of Ibadan, Ibadan, Nigeria
  • 73 Department of Ophthalmology, University of Benin, Benin City, Nigeria
  • 74 Center for Advanced Neurological Research, Nitte University, Karnataka, India
  • 75 Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité- Universiätsmedizin Berlin, Berlin, Germany
  • 76 Department of Ophthalmology of Ramon y Cajal Hospital, and Alcala University Madrid, Madrid, Spain
  • 77 Sydney Neurology, Sydney, NSW, Australia
  • 78 Department of Neurology, Medical University of Lublin, Lublin, Poland
  • 79 Department of General and Pediatric Ophthalmology Medical University of Lublin, Lublin, Poland
  • 80 Grupo de Investigación Biomedicina, Faculty of Medicine, Fundacion Universitaria Autonoma de las Americas, Risaralda, Colombia
  • 81 Department of Ophthalmology, University Hospital of Bordeaux, Bordeaux, France
  • 82 Department of Neurology, Centro Hospitalar Universitário São João and Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal
  • 83 Department of Ophthalmology, Hospital Clinic of Barcelona, Barcelona, Spain
  • 84 Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
  • 85 Department of Ophthalmology and Visual Science, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
  • 86 Department of Neurology, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Türkiye
  • 87 Neuro-Ophthalmology Unit at Rabin Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
  • 88 Department of Ophthalmology, University of Mississippi Medical Center, Jackson, MS, USA
  • 89 Department of General Planning, Ho Chi Minh City Eye Hospital, Ho Chi Minh City, Vietnam
  • 90 Department of Neurology, National Paediatric Hospital Dr Juan P Garrahan, Buenos Aires, Argentina
  • 91 Department of Ophthalmology, Faculty of Medicine, Ho Chi Minh City University of Medicine and Pharmacy, and Hai Yen Vision Institute, Ho Chi Minh City, Vietnam
  • 92 Department of Neurology and Reflexology, The Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
  • 93 Department of Neurology, Cliniques Universitaires Saint-Luc Brussels, Belgium; Neurochemistry Unit, Institute of Neuroscience, UCLouvain, Brussels, Belgium
  • 94 Department of Ophthalmology, Taipei Veterans General Hospital, National Yang-Ming Chiao-Tung University School of Medicine, Taipei, Taiwan
  • 95 Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
  • 96 Department of Neurology, Auckland City Hospital, Auckland, New Zealand
  • 97 Department of Neurology, Ain Shams University Hospitals, Cairo, Egypt
  • 98 Department of Ophthalmology, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
  • 99 Department of Neurology, Department of Population Health, and Department of Ophthalmology, New York University Grossman School of Medicine, New York, NY, USA
  • 100 Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, Faculty of Brain Sciences, London, UK
Lancet Neurol, 2022 Dec;21(12):1120-1134.
PMID: 36179757 DOI: 10.1016/S1474-4422(22)00200-9

Abstract

There is no consensus regarding the classification of optic neuritis, and precise diagnostic criteria are not available. This reality means that the diagnosis of disorders that have optic neuritis as the first manifestation can be challenging. Accurate diagnosis of optic neuritis at presentation can facilitate the timely treatment of individuals with multiple sclerosis, neuromyelitis optica spectrum disorder, or myelin oligodendrocyte glycoprotein antibody-associated disease. Epidemiological data show that, cumulatively, optic neuritis is most frequently caused by many conditions other than multiple sclerosis. Worldwide, the cause and management of optic neuritis varies with geographical location, treatment availability, and ethnic background. We have developed diagnostic criteria for optic neuritis and a classification of optic neuritis subgroups. Our diagnostic criteria are based on clinical features that permit a diagnosis of possible optic neuritis; further paraclinical tests, utilising brain, orbital, and retinal imaging, together with antibody and other protein biomarker data, can lead to a diagnosis of definite optic neuritis. Paraclinical tests can also be applied retrospectively on stored samples and historical brain or retinal scans, which will be useful for future validation studies. Our criteria have the potential to reduce the risk of misdiagnosis, provide information on optic neuritis disease course that can guide future treatment trial design, and enable physicians to judge the likelihood of a need for long-term pharmacological management, which might differ according to optic neuritis subgroups.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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