Integrated Diagnosis and Therapeutic Protocols in the Treatment of Optic Neuritis

Optic neuritis (ON) is a neuroinflammatory condition characterized by vision loss, eye pain, and dyschromatopsia, with distinct etiologies that include multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and anti-MOG antibody-associated disease (MOGAD). This narrative review analyzes diagnostic approaches and acute and maintenance treatment protocols for the management of ON. Etiological differentiation is based on clinical evaluation, dedicated magnetic resonance imaging (MRI) of the orbits, optical coherence tomography (OCT), visual evoked potentials, and serological detection of AQP4-IgG and MOG-IgG antibodies via cell-based assays. In the acute phase, pulse therapy with intravenous methylprednisolone accelerates visual recovery, and plasmapheresis is indicated in severe or refractory cases, especially in NMOSD. Corticosteroid tapering requires long-term follow-up in MOGAD to prevent relapses. Prevention of recurrences requires immunotherapeutic strategies specific to each pathogenic profile. Early diagnostic and therapeutic integration and multimodal monitoring are critical for mitigating neuroaxonal damage and optimizing long-term functional outcomes.