Optic Neuritis (Retrobulbar Neuritis)

Inflammation of the optic nerve. Commonly associated conditions include autoimmune disorders such as MULTIPLE SCLEROSIS, infections, and granulomatous diseases. Clinical features include retro-orbital pain that is aggravated by eye movement, loss of color vision, and contrast sensitivity that may progress to severe visual loss, an afferent pupillary defect (Marcus-Gunn pupil), and in some instances optic disc hyperemia and swelling. Inflammation may occur in the portion of the nerve within the globe (neuropapillitis or anterior optic neuritis) or the portion behind the globe (retrobulbar neuritis or posterior optic neuritis).

Also Known As:

Networked: 1179 relevant articles (58 outcomes, 126 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Multiple Sclerosis
2.	Transverse Myelitis (Necrotizing Myelitis)
3.	Neuromyelitis Optica (Devic's Disease)
4.	Optic Nerve Diseases (Optic Neuropathy)
5.	Myasthenia Gravis

Experts

1.	Balcer, Laura J: 14 articles (11/2015 - 03/2002)
2.	Diem, Ricarda: 14 articles (06/2014 - 10/2004)
3.	Bähr, Mathias: 12 articles (03/2014 - 10/2004)
4.	Sättler, Muriel B: 11 articles (03/2014 - 10/2004)
5.	Plant, Gordon T: 11 articles (01/2011 - 08/2004)
6.	Sellebjerg, F: 10 articles (12/2015 - 05/2000)
7.	Frohman, Elliot M: 10 articles (11/2015 - 02/2006)
8.	Calabresi, Peter A: 10 articles (11/2015 - 02/2006)
9.	Miller, David H: 9 articles (01/2015 - 08/2004)
10.	Frederiksen, J L: 8 articles (12/2015 - 05/2000)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Optic Neuritis:

1.	Adrenal Cortex Hormones (Corticosteroids)IBA 07/01/2012 - "In optic neuritis associated with NMO, sequential treatment with pulsed intravenous corticosteroids and PE is more effective than standard monotherapy with corticosteroids on visual acuity outcome." 12/01/2001 - "Corticosteroids remain the mainstay of treatment of optic neuritis, but alternate dosages and routes of administration are undergoing investigation. " 06/01/1993 - "To determine the efficacy of corticosteroids as treatment for acute demyelinative optic neuritis after completion of 1 year of patient follow-up in the Optic Neuritis Treatment Trial. " 01/01/2015 - "Treatment with corticosteroids improved her clinical symptoms and decreased the size of the lesions, but the brain lesions and bilateral optic neuritis recurred within one month. " 06/01/2010 - "For a presumptive diagnosis of retrobulbar optic neuritis, he was treated with intravenous corticosteroids, and vision improved transiently. "
2.	Retinaldehyde (Retinal)IBA 01/01/2012 - "Eyes of MS patients without a previous optic neuritis showed a significant reduction of both retinal nerve fibre layer (RNFL) thickness and total macular volume (TMV) compared to healthy controls independent of the MS subtype (P < 0.001 for all subtypes). " 10/30/2012 - "The primary objective of this study was to explore the potential influence of gender on recovery from optic neuritis (ON) by determining whether differences in retinal nerve fiber layer (RNFL) thickness can be detected between men and women 6 months after an ON event. " 01/01/2012 - "An optical coherence tomography study on degeneration of retinal nerve fiber layer in rats with autoimmune optic neuritis." 02/01/2011 - "To study the relationship between retinal nerve fiber layer (RNFL) thickness measurements from time domain (Stratus) and spectral domain (Cirrus HD) optical coherence tomography (OCT) in subjects with optic neuritis. " 09/01/2010 - "Optical coherence tomography-measured retinal nerve fibre layer loss after 6 months is a suitable outcome measure for proof-of-concept trials of acute neuroprotection in optic neuritis."
3.	MethylprednisoloneFDA LinkGeneric 04/22/1999 - "To assess the efficacy of oral high-dose methylprednisolone in acute optic neuritis (ON). " 11/01/2001 - "Here, we report a serial analysis of CSF CXCL10 and CCL2 concentrations in 22 patients with attacks of MS or acute optic neuritis (ON) treated with methylprednisolone, and 26 patients treated with placebo in two randomized controlled trials. " 11/01/2012 - "Based on the hypothesis of optic neuritis, intravenous methylprednisolone pulse was performed with no success. " 04/01/2012 - "Where neuro-imaging is not readily available, intravenous methylprednisolone may be considered as initial treatment to cover both optic neuritis/optic perineuritis in patients with severe visual loss." 02/01/2012 - "The current treatment of pediatric optic neuritis consists of 3 to 5 days of intravenous methylprednisolone (4-30 mg/kg per day), followed by a prolonged oral corticosteroid taper. "
4.	SteroidsIBA 01/22/2004 - "Steroids seem to be beneficial in the treatment of optic neuritis in childhood. " 09/01/2002 - "The recommended treatment for optic neuritis is intravenous steroids, as shown in the Optic Neuritis Treatment Trial (ONTT). " 10/01/1993 - "The role of steroids in idiopathic optic neuritis has been clarified by the Optic Neuritis Treatment Trial. " 11/01/2015 - "Should patients with optic neuritis be treated with steroids?" 11/01/2014 - "This cohort was small, but the results do not identify any reason to deviate from the common approach of optic neuritis treatment, which is 2 weeks of steroids."
5.	Prednisolone (Predate)FDA LinkGeneric 07/01/1998 - "He had suffered from retrobulbar optic neuritis at the age of 11 years which was improved gradually by prednisolone. " 10/01/2008 - "In this study, patients with optic neuritis were treated with high-dose prednisolone. " 01/01/1995 - "The effect of oral prednisolone on visual evoked potential latencies in acute optic neuritis monitored in a prospective, randomized, controlled study." 10/01/2015 - "She was diagnosed with bilateral optic neuritis and treated with intravenous methyl prednisolone for 10 days. " 10/01/2009 - "He had already been treated with systemic prednisolone owing to the occurrence of retrobulbar neuritis. "
6.	Immunoglobulins (Immunoglobulin)IBA 12/01/1992 - "Improved vision after intravenous immunoglobulin in stable demyelinating optic neuritis." 03/08/2005 - "A double-blind, randomized trial of IV immunoglobulin treatment in acute optic neuritis." 06/12/2001 - "A randomized trial of intravenous immunoglobulin in inflammatory demyelinating optic neuritis." 01/01/1988 - "All 7 MS patients had abnormal visual evoked response, 3/4 abnormal somatosensory evoked response and 5/6 intrathecal immunoglobulin production, when examined at onset of optic neuritis or at follow-up. " 08/01/2004 - "To our knowledge, there is only one experience of treatment of optic neuritis with intravenous immunoglobulin in multiple sclerosis, even if therapeutic trials are used in the therapy of multiple sclerosis. "
7.	ErythropoietinFDA Link 08/01/2012 - "A randomized, double-blind, phase 2 study of erythropoietin in optic neuritis." 08/01/2012 - "These results give the first indications that erythropoietin might be neuroprotective in optic neuritis." 08/01/2012 - "Based on findings in animal models of autoimmune optic nerve inflammation, we have assessed the safety and efficacy of erythropoietin in patients presenting with a first episode of optic neuritis. " 04/01/2012 - "To investigate the safety, tolerability, and short-term efficacy of treatment with erythropoietin in patients with optic neuritis as a first demyelination event. " 04/01/2012 - "Erythropoietin for acute multiple sclerosis in patients with optic neuritis as a first demyelination event."
8.	Immunoglobulin G (IgG)IBA 03/01/2014 - "In 5 patients, additional clinical features suspicious for MS were present, including prior optic neuritis (n = 2), multiple disseminated lesions (n = 3), and elevated immunoglobulin G index (n = 2). " 02/01/2013 - "The finding of NMO-IgG in patients with optic neuritis foreshadows a bad prognosis and relapses. " 02/01/2013 - "Most of the NMO patients with NMO-IgG had additional attacks of optic neuritis within a short time from the initial event. " 02/01/2013 - "A total of 50% of the 107 patients with NMO-IgG fulfilled the revised criteria of NMO; 38 patients had a single attack of optic neuritis or long lesion in the spinal cord and 15 patients presented with an opticospinal type of MS. The visual acuity following a single attack of optic neuritis remained significantly lower in NMO patients as compared to MS patients. " 02/01/2013 - "Based on the presenting symptomatology of the patients, we identified the cases with optic neuritis and various parameters that may differentiate between NMO and MS. NMO-IgG were evaluated by ELISA. "
9.	Intravenous Immunoglobulins (IVIG)FDA Link 11/01/2001 - "In one of our cases, intravenous immunoglobulins were effective in controlling an optic neuritis. " 11/01/2008 - "Winning combination: the additive/synergistic benefits of IVIg in corticosteroid refractory optic neuritis." 12/01/2007 - "[High-dose intravenous immunoglobulins for treatment of optic neuritis in Guillain-Barré syndrome]." 08/02/2003 - "Combination of high-dose intravenous immunoglobulins and itraconozole in treating chronic mycotic demyelinating optic neuritis." 03/08/2005 - "There was no effect of IV immunoglobulin (IVIG) on long-term visual function following acute optic neuritis, nor was there an effect of IVIG treatment in reducing latency on visual evoked potentials and thus preserving function of axons of the optic nerve."
10.	Dexamethasone (Maxidex)FDA LinkGeneric 09/01/2007 - "Intravenous dexamethasone is an effective treatment for optic neuritis. " 09/01/2006 - "Treatment with intravenous pulsed dexamethasone led to rapid recovery of vision in acute optic neuritis, without any serious side effects." 09/01/2006 - "To evaluate the clinical profile, response to dexamethasone treatment and visual function outcome in Indian patients with acute optic neuritis. " 09/01/2006 - "Visual outcome after intravenous dexamethasone therapy for idiopathic optic neuritis in an Indian population: a clinical case series." 09/01/1965 - "[Four cases of optic neuritis favorably treated with an intraspinal administration of dexamethasone (decadron) solution]."

Therapies and Procedures

1.	Plasma Exchange 10/01/2013 - "Plasma exchange is effective in a 13-year-old girl with steroid-resistant bilateral optic neuritis." 09/01/2014 - "Subsequent treatment with plasma exchange improved her optic neuritis symptoms. " 08/01/2012 - "Until now, the significance of plasma exchange (PE) as a treatment for steroid-unresponsive optic neuritis (ON) is still unclear because placebo-controlled and larger studies are missing. " 10/01/2015 - "Bilateral optic neuritis in a patient with Behçet's disease who respond to therapeutic plasma exchange." 09/01/2013 - "Immunosuppression and plasma exchange are the mainstays of therapy for NMO optic neuritis. "
2.	Decompression 10/01/1994 - "We consider decompression of the optic nerve to be effective for the treatment of rhinogenous retrobulbar optic neuritis." 07/01/1973 - "[A case of Graves-Basedow optic neuritis treated by orbital decompression using Ogura's technic]." 01/01/1953 - "[Orbital decompression of the optic canal in retrobulbar neuritis]." 12/01/2000 - "Over the past decade major clinical trials, such as the Optic Neuritis Treatment Trial and Ischemic Optic Neuropathy Decompression Trial, have proven that currently available treatment options for demyelinating and ischemic optic neuropathies are ineffective and can even be harmful. " 12/01/2001 - "This review presents highlights and updates from of the most significant clinical trials in neuro-ophthalmology to date, the Optic Neuritis Treatment Trial, the Controlled High-Risk Avonex Multiple Sclerosis Prevention Study, and the Ischemic Optic Neuropathy Decompression Trial. "
3.	Aftercare (After-Treatment) 04/01/2000 - "The NEI-VFQ was administered to 244 patients 5 to 8 years after treatment for an episode of acute optic neuritis as part of the Optic Neuritis Treatment Trial. " 01/01/2015 - "Both length of the Gd enhancing lesion (r = -0.38; p = 0.001) and the T2 lesion (r = -0.25; p = 0.03) of the optic nerve in acute optic neuritis showed a medium correlation with visual acuity after treatment. " 03/01/2010 - "After treatment was stopped on day 14, mice rapidly developed EAE and optic neuritis by day 18, but RGC loss was still reduced. " 03/01/2003 - "After treatment, 60 per cent of the isolated optic neuritis patients and 24 per cent of the optic neuritis patients with demyelinative disease had a visual acuity of 6/12 or better respectively. " 03/01/2003 - "After treatment, 45 patients (52 eyes) with isolated optic neuritis and 14 patients (25 eyes) with optic neuritis with demyelinative disease who were followed-up for more than 10 days were studied. "
4.	Immunomodulation 03/01/2010 - "Results suggest that chronic immunomodulation may prevent recurrent optic neuritis and RGC damage." 08/01/2014 - "Despite the success of recently introduced immunomodulatory therapies, multiple sclerosis and its ophthalmic manifestation as optic neuritis lead to irreversible axonal degeneration. " 06/01/2005 - "The role of corticosteroid therapy alone in reducing the risk of subsequent MS is unclear, but recent studies suggest that the combination of immunomodulation agents (IMAs) and corticosteroids significantly reduces the later development of MS. Current research indicates that, contrary to previous doctrine, axonal damage is an early finding in MS. The risk of MS after optic neuritis may be predicted. " 06/01/2005 - "Analysis of both laboratory and clinical evidence supporting the use of corticosteroids, immunomodulation agents, and other modalities in the treatment of optic neuritis and MS. Although treatment of optic neuritis with corticosteroids may hasten visual recovery to a minor degree, it has no long-term beneficial effect on visual outcome. " 11/01/2008 - "When flupirtine was combined with interferon-beta, an established immunomodulatory therapy for MS, visual functions of the animals were improved during the acute phase of optic neuritis. "
5.	Oral Administration 10/01/1996 - "Her optic neuritis improved following oral administration of prednisolone and retrobulbar injections of dexamethasone. " 10/25/2009 - "Since it can cause irreversible visual loss, especially in the optic-spinal form of MS or neuromyelitis optica (NMO), the present study was conducted to assess the effects of geranylgeranylacetone (GGA) on optic neuritis in the experimental autoimmune encephalomyelitis (EAE) mouse model of MS. Myelin oligodendrocyte glycoprotein-induced EAE mice received oral administration of GGA at 500 mg/kg or vehicle once daily for 22 days. "