Optic neuritis
Typical versus atypical optic neuritis, the 2022 international criteria, AQP4 and MOG testing, what the ONTT showed about steroids, and the MS risk after a first episode.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Inflammatory optic neuropathy. The typical patient is a woman aged 20 to 45 with subacute monocular visual loss and pain on eye movement.
- Most cases are idiopathic or MS-associated and recover well. About 90% reach 6/12 or better by a year (ONTT).
- Every patient needs MRI brain and orbits for MS risk, and AQP4 and MOG antibodies when anything is atypical.
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Sources
- Diagnosis and classification of optic neuritis (Petzold A et al. Lancet Neurology 2022;21(12):1120-1134)Lancet Neurology, 2022
- Diagnosis of multiple sclerosis: 2024 revisions of the McDonald criteriaMontalban X et al., Lancet Neurology 2025;24(10):850-865, 2024 (published 2025)
- A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis (Beck RW et al. NEJM 1992;326:581-588)New England Journal of Medicine (Optic Neuritis Study Group), 1992
- Multiple sclerosis risk after optic neuritis: final Optic Neuritis Treatment Trial follow-up (Arch Neurol 2008;65(6):727-732)Optic Neuritis Study Group, Archives of Neurology, 2008
- Diagnosis of myelin oligodendrocyte glycoprotein antibody-associated disease: international MOGAD Panel proposed criteria (Banwell B et al. Lancet Neurology 2023;22(3):268-282)Lancet Neurology, 2023
- International consensus diagnostic criteria for neuromyelitis optica spectrum disorders (Wingerchuk DM et al. Neurology 2015;85(2):177-189)Neurology, 2015
- Therapeutic Guidelines: NeurologyAU/NZTherapeutic Guidelines Limited
- Assessing Fitness to Drive (AP-G56), Vision and eye disordersAU/NZAustroads and National Transport Commission, 2022
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy