OPTIC NEUROPATHY OF SYSTEMIC ORIGIN: WHEN TO SUSPECT A NEUROLOGICAL/SYSTEMIC CAUSE RATHER THAN AN EXCLUSIVELY OPHTHALMOLOGIC CAUSE
Keywords:
Optic neuropathies; Optic neuritis; Multiple sclerosis; Neuromyelitis optica spectrum disorders; MOG antibodies; Giant cell arteritis; Differential diagnosisAbstract
DOI: https://doi.org/10.46296/yc.v10i18.0858
Abstract
Optic neuropathies comprise inflammatory, ischemic, compressive, infiltrative, toxic-nutritional, and infectious disorders of the optic nerve. Although typical optic neuritis related to multiple sclerosis remains a common diagnosis in young adults, a substantial subset of cases reflects neurological or systemic disease that requires early recognition, including giant cell arteritis, neuromyelitis optica spectrum disorders, and compressive chiasmal lesions. This condensed review summarizes literature published between 2015 and 2025 and offers a practical framework based on red flags, early imaging, and targeted testing. Atypical age, bilateral involvement, recurrence, profound visual loss, marked disc edema, systemic symptoms, or visual field defects inconsistent with typical optic neuritis should trigger broader etiologic evaluation. Brain and orbital magnetic resonance imaging with gadolinium, combined with hypothesis-driven laboratory testing, helps reduce diagnostic error and enables time-sensitive therapies that may improve visual outcomes.
Keywords: Optic neuropathies; Optic neuritis; Multiple sclerosis; Neuromyelitis optica spectrum disorders; MOG antibodies; Giant cell arteritis; Differential diagnosis.
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