[The era of precision diagnosis and treatment for optic neuritis: advances in diagnostic classification, biomarkers and therapeutic strategies].

Since the release of the Evidence-based guidelines for diagnosis and treatment of demyelinating optic neuritis in China (2021), significant progress has been achieved in the diagnostic classification, biomarker detection and targeted therapy of optic neuritis. A quantitative evaluation system combining multimodal imaging and serological antibody testing has been established for clinical application. The updated McDonald criteria have incorporated the optic nerve into the lesion localization of multiple sclerosis. Detection of aquaporin-4 (AQP4) and myelin oligodendrocyte glycoprotein (MOG) antibodies serves as a key tool for the definitive diagnosis of neuromyelitis optica spectrum disorder and MOG antibody-associated disease. Plasma exchange can improve the prognosis of severe cases, and biological agents represent the first-line therapeutic strategy for AQP4-positive patients. Considering the current domestic status of antibody detection capabilities and drug accessibility, this article proposes implementing routine antibody screening at initial diagnosis, optimizing multidisciplinary collaboration models, and constructing a real-world clinical data system.