TABLE 3–2.

Ophthalmic Diagnostics in Optic Neuritis

Diagnosis	Visual Evoked Potentials	Visual Fields	Optical Coherence Tomography
Multiple sclerosis	P100 latency prolonged with normal or mildly reduced amplitude	Diffuse field loss, central scotoma	Acute peripapillary retinal nerve fiber layer (RNFL) thickening with subsequent peripapillary RNFL and GC+IPL thinning
Neuromyelitis optica (NMO) spectrum disorder	P100 latency prolonged with mildly reduced amplitude, reduced amplitude with normal latency absent response	Total loss, central, quadrant, altitudinal	Severe peripapillary RNFL thinning
MOG-IgG	P100 latency prolonged with normal or mildly reduced amplitude	Not reported	Peripapillary RNFL thinning and GC+IPL thinning, worsens with recurrence
Seronegative (AON, RION, CRION)	P100 latency prolonged with mildly reduced amplitude, reduced amplitude with normal latency (CRION)	Central scotoma, constriction, altitudinal (CRION)	Severe peripapillary RNFL thinning worsening with recurrent disease, microcystic macular edema
Granulomatous (sarcoid, granulomatosis with polyangiitis)	P100 latency prolonged with normal or mildly reduced amplitude	Central scotomas, occasional hemianopic and altitudinal defects	Peripapillary RNFL thickening, retinal and subretinal fluid, choroidal nodules (sarcoid)
Autoimmune (Sjögren syndrome, systemic lupus erythematosus)	P100 latency prolonged with normal or mildly reduced amplitude	Variable	Peripapillary RNFL thinning, choroidopathy (systemic lupus erythematosus)
GFAP-IgG	Normal	Arcuate defects, enlarged blind spot, diffuse loss	Peripapillary RNFL thickening
Paraneoplastic (CRMP-5)	P100 latency prolonged; electroretinogram may be abnormal	Arcuate defects, constriction; enlarged blind spot, paracentral scotoma, diffuse loss	Peripapillary RNFL thickening, retinal hyperreflective material
Neuroretinitis	P100 latency normal or modestly prolonged; electroretinogram normal	Central or centrocecal scotoma	Peripapillary RNFL thickening, outer retinal fluid or hyperreflective material
Syphilis	P100 latency prolonged	Variable	Peripapillary RNFL thickening, choroidopathy, retinal or subretinal fluid
Lyme disease	P100 latency prolonged with normal or mildly reduced amplitude; latency may be normal in neuroretinitis	Central or centrocecal scotoma	Peripapillary RNFL thickening, outer retinal fluid or hyperreflective material if neuroretinitis
Tuberculosis	Not reported	Variable, but enlarged blind spot and central scotoma are most common	Peripapillary RNFL thickening if disc edema, rare choroidal lesions
Viral infection	Not reported	Variable	Retinal thinning, cystic fluid, hyperreflective lesions with retinitis and necrosis, outer and inner retinal hyperreflective material with chorioretinitis

AON = autoimmune optic neuropathy; CRION = chronic relapsing inflammatory optic neuropathy; CRMP-5 = collapsin response mediator protein-5; GC+IPL = ganglion cell plus inner plexiform layer thickness; GFAP-IgG = glial fibrillary acidic protein immunoglobulin G; MOG-IgG = myelin oligodendrocyte glycoprotein immunoglobulin G; RION = relapsing isolated optic neuritis.