Updates on Imaging Features of Optic Neuritis and Mimicking Syndromes

Optic neuritis is a frequent cause of optic neuropathy with diverse etiologies, most commonly multiple sclerosis (MS), neuromyelitis optica spectrum disorder, and myelin oligodendrocyte glycoprotein antibody-associated disease. MRI of the orbits and brain is the imaging gold standard, enabling diagnosis, characterization of optic nerve involvement, and distinction between demyelinating and atypical causes. Key radiologic features include lesion length, laterality, and chiasmal or sheath extension, which help differentiate MS from antibody-mediated disorders. Optical coherence tomography complements MRI by quantifying retinal axonal loss. Awareness of pediatric variants and atypical mimics is essential for accurate radiologic interpretation and management guidance.