An Indian study conducted before the commencement of the optic neuritis treatment trial (ONTT) had indicated that the clinical profile of ON in our country may be different from that presented in the Western literature.Ī research on optic neuritis from India revealed a clinical profile and outcome comparable to the majority of studies from the Asian continent and vastly different from the West. Western data suggest that at least 50% of patients with ON will eventually develop MS, but studies from Asia and Africa present a contrasting scenario. We preferentially selected papers that have been published in the last 10 years, but we have also included relevant older references. We also searched through our archives for the references. ![]() If referenced in a selected English paper, we contemplated papers in other languages too. We searched PubMed for studies published in English between 1970 and February 2020, incorporating the general search term “atypical optic neuritis” with more precise search terms relevant to subheadings - e.g., “neuromyelitis optica,” “myelin oligodendrocyte glycoprotein antibody,” “infectious optic neuritis,” “optical coherence tomography,” “corticosteroid,” “visually evoked potential,” “magnetic resonance imaging,” etc., References from identified studies have been reviewed and included if deemed appropriate, valid, and scientifically important. Due to their clinically overlapping characteristics, a reliable biomarker is needed to distinguish between typical and atypical ON. It is, therefore, very important to distinguish between typical and atypical ON, especially in the early stages of presentation. Such types of ON are generally seen in Asia and vary from traditional ON in terms of etiologies, management strategies, and ultimate neurological outcomes. ON with various etiologies, other than MS, is classified as “atypical ON.” Atypical ON is usually seen as an early example of neuromyelitis optica (NMO) or NMO spectrum disorder (NMOSD). IDON is commonly observed in the early stages of MS, chiefly in Western countries, and this form of ON is usually referred to as “typical ON”. Initial presentation in approximately 20% of MS patients will be with IDON, with 50% of MS patients developing IDON during their disease. It has been seen earlier that acute inflammatory demyelinating ON (IDON) is very closely related to multiple sclerosis (MS). A gamut of etiologies can be responsible for ON and are broadly classified as typical and atypical. They also have dyschromatopsia with pain on ocular movements at presentation. The patients present with partial to complete vision loss within a few days of onset. Optic neuritis (ON) refers to a group of conditions that involve inflammation of the optic nerve.
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