Recent advances in optic neuritis related to multiple sclerosis

Area of Science:

• Neuro-ophthalmology
• Neuroimmunology
• Medical imaging

Background:

• Optic neuritis (ON) is a significant cause of visual impairment in multiple sclerosis (MS).
• Accurate detection and monitoring of axonal loss are crucial for managing MS progression.
• Traditional methods for assessing visual function in ON have limitations.

Purpose of the Study:

• To review advancements in detecting and quantifying optic neuritis (ON) over the past 15 years.
• To highlight the role of optical coherence tomography (OCT) in monitoring retinal nerve fibre layer (RNFL) changes.
• To discuss new methods for assessing visual acuity (VA) and visual evoked potentials (VEPs) in MS.

Main Methods:

• Review of recent developments in optical coherence tomography (OCT) for RNFL thickness measurement.
• Analysis of novel clinical trial methods for visual acuity (VA) testing (e.g., high/low contrast charts, contrast sensitivity).
• Inclusion of multi-focal visual evoked potentials (mfVEPs) for detecting subtle visual impairment and recovery.

Main Results:

• OCT provides precise measurements of RNFL, aiding in the quantification of axonal loss in MS.
• New VA testing methods offer more sensitive assessments of visual function in ON.
• mfVEPs can detect early visual dysfunction and track functional recovery in ON patients.
• Emerging OCT techniques may elucidate links between optic nerve, retinal, and brain atrophy across MS subtypes.

Conclusions:

• Recent technological advancements significantly improve the detection and monitoring of ON in MS.
• OCT and advanced visual function tests are valuable tools for assessing disease progression and treatment efficacy.
• Further research into the relationship between ocular and brain atrophy is warranted, particularly in early MS stages.
• The optimal treatment strategy for clinically isolated syndrome (CIS) remains an area of ongoing debate.