Optic neuritis is a demyelinating disorder in which the myelin sheath of the optic nerve is getting damaged and hence the inflammation of the optic nerve arises. It can occur in both adulthood and childhood and also shares similar etiological factors. The etiological factors responsible for optic neuritis are limited and there is not much of the diagnosis left once the optic neuritis disease is confirmed.
What Leads To Optic Neuritis?
The most common etiology associated with optic neuritis is multiple sclerosis in both adults and children. However, the rate of developing multiple sclerosis is very less in children. Another etiological factor associated with optic neuritis is neuromyelitis optica in which there is optic neuritis in addition to the involvement of the spinal cord in the form of transverse myelitis which can be sometimes extensive.
It can also occur as a single disorder without any syndromic association which is more common in children. The usual pathology responsible for optic neuritis is autoimmune damage caused by the immune system of the body. It can be triggered due to various reasons like most commonly because of viral infections and post-vaccination.(1) These etiological factors are relatively common in children and are very rare in adults.
Can Optic Neuritis Be Cured?
Since optic neuritis is a demyelinating disease it is very difficult to arrest the progression of the disease but with few of the drugs, it is possible to prevent the relapse. The primary cure of the disease is not possible because the damage to the nerve is permanent. Since the disease is autoimmune, there is always the risk of relapse in it which makes the condition even worse because of repeated damage to the nerve.
The primary treatment for the disorder of optic neuritis is medical in the form of steroid therapy, monoclonal antibodies, etc. Once the diagnosis of optic neuritis is confirmed, steroid therapy is initiated immediately in the form of prednisolone and the dosage is 250 milligram, 4 times a day for 3 days. Intravenous steroid therapy is also used in the early regression of the disease. In a clinical trial of monoclonal antibody known as eculizumab, it was found that this drug was able to prevent the relapse of the disease in about 92 to 96 % of the cases as compared to Placebo.
According to many studies done on the disorder, when the patient is suffering from optic neuritis in association with the syndrome of neuromyelitis optica then the monoclonal antibody known as rituximab is the most efficient drug to be found to regress the disease.(2)
If the patient is also suffering from multiple sclerosis, then the treatment with interferon beta, glatiramer or natalizumab should be considered. In a few of the clinical trials, even erythropoietin was also considered but not much of the results went into the favor of it. If the disease is remnant and a complete cure has not been achieved, then wearable glasses made of polycarbonate can be used for safety purposes.
Optic neuritis is a rare disease having very rare causative factors but has mostly autoimmune origin. It can occur in both adulthood as well as childhood but more commonly adults are affected. Due to the defect of demyelination the damage caused by it is usually permanent and also the syndromic association is found in a high number of cases. Multiple sclerosis and neuromyelitis optica are the most commonly associated syndromes with it.
The treatment is based upon the regression of the autoimmune response caused by the body and the most common drugs used for it are steroid therapy. Oral steroid therapy in the form of tablets and intravenous steroid therapy can both be used in the early diagnosed cases. Complete cure of the optic neuritis is not possible in nearly all of the cases.
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- How To Diagnose Optic Neuritis & What Is The Best Medicine For It?
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