Updates on the Acute and Maintenance Management of Optic Neuritis Including Multiple Sclerosis, Neuromyelitis Optica Spectrum Disorder, and Myelin Oligodendrocyte Glycoprotein Antibody Disease.

Optic neuritis is a common inflammatory optic nerve disorder. Acute management with high-dose corticosteroids accelerates visual recovery, while low-dose prednisone increases relapse risk. Plasma exchange benefits steroid-refractory cases; intravenous immunoglobulin (IVIG) is an alternative if plasma exchange is unavailable. Long-term, multiple sclerosis patients benefit from early high-efficacy disease-modifying therapies. Neuromyelitis optica spectrum disorder (NMOSD) requires immediate maintenance therapy with biologic agents like eculizumab and satralizumab to reduce relapses. Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) responds well to IVIG, with newer agents being studied. Prognosis varies, with good outcomes in MS and MOGAD, but lasting vision loss in NMOSD.