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The following is a summary of “Clinical and paraclinical characteristics of optic neuritis in the context of the McDonald Criteria 2017,” published in the March 2024 issue of Neurology by Jendretzky et al.

While optic neuritis is a common early sign of multiple sclerosis (MS) or clinically isolated syndrome (CIS), few studies analyze its characteristics under the latest 2017 McDonald criteria for diagnosing MS.

Researchers conducted a retrospective study reviewing patient records from academic centers (2010-2018) to assess clinical and paraclinical features of optic neuritis in the context of the 2017 McDonald criteria for diagnosing MS and CIS.

They utilized the 2017 McDonald criteria to categorize participants into three groups. MS optic neuritis (optic neuritis with confirmed MS), CIS optic neuritis (optic neuritis without confirmed MS), and suspected optic neuritis (sON). Clinical and paraclinical findings were compared across these groups to pinpoint predictors for CIS- or MS-optic neuritis.

The results showed 129 cases of MS, 108 cases of CIS, and 44 cases of sON. Among MS patients, 47% exhibited a combination of visual impairment, dyschromatopsia, and retrobulbar pain, compared to 42% of CIS patients and 30% of sON patients. Dyschromatopsia emerged as the strongest MS or CIS diagnosis indicator in the backward regression model. Additionally, a relative afferent pupillary defect was present in 56% of MS patients, optic nerve anomalies within magnetic resonance imaging were observed in 61%, and abnormal visual evoked potentials were detected in 81%.

Investigators concluded that incorporating additional paraclinical data may help diagnose optic neuritis since some patients with confirmed MS lacked all three classic symptoms.

Source: nature.com/articles/s41598-024-57199-4