Table 2.
Clinical features of different disease entities that may develop ON.
| Bilaterality | Severity and recurrence | Susceptible population | Visual acuity | MRI | Others | References | |
|---|---|---|---|---|---|---|---|
| MS-ON | Unilateral in most cases | Mild to moderate; monophasic in most cases | Young (averaged 32 years old) Caucasian women | Always recover within one month | Demyelinated lesions found in brain MRI; The lesions always disseminate in space and time. | Retrobulbar ON (65%) remains the major ON. Good response to corticosteroid therapy. | (7, 53, 55–59) |
| NMOSD-ON | Bilateral in most cases | Severe; relapsing frequently | Older than MS patients (more patients >50 or <18 years old); Asian or African women | Progress to even no light perception | LETM: more than 3 segments; The lesion of ON always locates posteriorly and mostly involves optic tract and chiasm; Always involve more than 50% optic nerve. | Resistant to corticosteroid and immunosuppressant therapy. Accompanied by intractable nausea. Cell-based assay is most sensitive for AQP4-Ab detection (99%). | (7, 53, 55, 57, 59–63) |
| MOGAD-ON | Bilaterality accounts for 40% | Recurrent cases accounts for 80%-93% | Two study reported 31 years old. One study reported 40 years old; Caucasian women. | Good recovery of visual acuity compared to NMOSD-ON | Involvement of optic nerve in MRI always locate at the anterior segment. | Optic disc swelling is more pronounced than MS-ON. ON is often isolated. | (64–67) |
| CRION | Unilateral or bilateral | Relapsing course | Webb's study reported 71% female. The predilection for age and race is not obvious. | Good vision recovery and pain resolution after steroid treatment | Variable | Seronegative AQP4 and cannot satisfy the Macdonald's criteria. | (14, 68, 69) |
| ADEM-ON | Higher rate of bilaterality | Rare relapsing cases; always monophasic | Children less than 10 years old | Poor visual acuity | The margin of lesion is poorly defined; Greater lesions (1–2 cm) compared with other etiologies in white matter; most lesions are supposed to emerge at the same age compared to dissemination in space and time for MS. | Virus infection was considered to be the potential origin of this disease since it might initiate the procession of demyelination. | (70–73) |
MS, multiple sclerosis; NMOSD, neuromyelitis optica spectrum disorder; MOGAD, myelin oligodendrocyte glycoprotein; CRION, Chronic relapsing inflammatory optic neuritis; LETM, longitudinal extensive transverse myelitis; ON, optic neuritis; CIS, clinically isolated syndrome; AQP4-Ab, aquaporin-4 antibodies; ADEM, acute disseminated encephalomyelitis.