Atypical Optic Neuritis
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Classic demyelinative optic neuritis is associated with multiple sclerosis and typically carries a good prognosis for visual recovery. This disorder is well characterized with respect to its presentation and clinical features by baseline data obtained through the optic neuritis treatment trial and numerous other studies. Atypical optic neuritis entails clinical manifestations that deviate from this classic pattern of features. Clinical signs and symptoms that deviate from the typical presentation should prompt consideration of less common etiologies. Atypical features to consider include lack of pain, simultaneous or near-simultaneous onset, lack of response to or relapse upon tapering from corticosteroids, or optic nerve head or peripapillary hemorrhages. The most important alternative etiologies to consider and the steps towards their respective diagnostic evaluations are suggested for these atypical features.
KeywordsOptic neuritis Ischemic optic neuropathy Neuromyelitis optica (NMO) Sarcoidosis Chronic relapsing inflammatory optic neuropathy Lyme borreliosis
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Conflict of Interest
Eric D. Gaier, Katherine Boudreault, Julie Falardeau, and Dean M. Cestari declare that they have no conflict of interest.
Joseph F. Rizzo III owns equity in Bionic Eye Technologies and Visus Technologies, which are working on an implanted and portable device for the blind, respectively. Dr. Rizzo also serves as Medical Director for Neurology and Ophthalmology for Magic Leap, Inc., which is developing a head-mounted “gaming” device.
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This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
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