The clinical profile and therapeutic outcome of patients diagnosed with "atypical" optic neuritis.

PURPOSE: Our aim was to evaluate the clinical characteristics and prognosis of patients diagnosed with atypical optic neuritis (AON).

METHODS

We performed a retrospective study in patients with AON collected between 1991 and 2024. Clinical features, laboratory findings, and treatment modalities of patients with AON were investigated and the relationship between therapeutic approaches and the visual prognosis of these patients were evaluated.

RESULTS

Eighty-eight patients with AON were evaluated and 51 patients were included in the study. Patients were divided in two groups (Group 1: full recovery, Group 2: partial and no recovery). Anti-MOG antibodies were positive in 8 patients. Seven patients out of 8 had full recovery whereas 1 patient had partial recovery. Among 7 patients with AQP4-Ab positivity, 4 patients had no recovery, 1 patient had partial recovery and 2 patients had full recovery. MOG-Ab positivity and intravenous methylprednisolone (IVMP) treatment in patients with full recovery were found to be significantly higher than in patients with partial recovery and no recovery (p = 0.011 and p = 0.010 respectively). Patients who were treated with plasma exchange (PE), intravenous immunoglobulin (IVIg) and immunsupressive agents had longer recovery time according to Kaplan -Meier survival curves (p = 0.023, p = 0.039 and p = 0.032).

CONCLUSION

MOG-Ab positivity and IVMP treatment are related with better visual outcome. Early diagnosis and treatment of AON are extremely important to rescue vision. Treatment in patients with AON should be started as soon as possible, even if the serological status is not known at the setting of ON.