Recent trends in the management of optic neuritis

Optic neuritis (ON) is an inflammatory optic neuropathy characterized by acute or subacute visual loss, dyschromatopsia, and pain on eye movements. It comprises a heterogeneous group of disorders, broadly classified into typical ON associated with multiple sclerosis and atypical ON, including neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein antibody-associated disease. Typical ON generally has a favorable prognosis, whereas atypical forms are often severe, bilateral, and recurrent with poorer visual outcomes. Advances in immunopathogenesis and the identification of biomarkers such as AQP4-IgG, MOG-IgG, glial fibrillary acidic protein, and neurofilament light chain have improved diagnostic accuracy and disease stratification. High-dose intravenous methylprednisolone remains the mainstay of acute management, with plasma exchange indicated in severe or refractory cases. Long-term immunotherapy is essential in preventing relapses. Early recognition and appropriate etiological classification are critical for optimizing visual and neurological outcomes.