Ophthalmic neuritis (optic neuritis) is an eye disease that occurs most commonly in women between the ages of 18-45, with unilateral painful vision loss. It occurs in the form of an attack as a result of the deterioration of the immune system. There is also a decrease in color sensation and brightness in the painful eye. In approximately 1/3 of the patients, edema occurs in the anterior side of the optic nerve, and in most cases, involvement of the nerve near the brain (backward) occurs. In the diagnostic phase, VEP (evoked potential test), OCT (Optical Coherence Tomography Scanner) and nerve fiber visualization and computerized visual field examination are used. Intracranial lesion is investigated with brain MRI. The number and shape of these lesions (spots) are important in determining the risk of MS. MS is a chronic brain disorder that occurs in attacks.
Optic neuritis may be the first initial manifestation of MS. Optic nerve disease is largely resolved in 3-5 weeks with treatment. However, recurrence can be seen in these optic neuritis attacks. The recurrence rate within 10 years is 35%. Optic neuritis is detected with a probability of 50% at one stage of MS disease, and is the first sign of MS in 20% of patients. The risk of MS after optic neuritis is 30% in the first 5-7 years, and around 75% in women in 15-20 years. MS attacks may occur as optic neuritis, double vision, loss of balance, sleep in the arms and legs, and loss of strength. In the treatment of optic neuritis, high-dose cortisone administration with serum and the use of interferon in cases where the possibility of MS increases are current approaches. The course of the disease after optic neuritis can be determined by periodic OCT nerve fiber analysis. If the thinning of the OCT nerve fibers is increasing, the number of plaques in the brain is also increasing. In this disease, follow-up with OCT and VEP tests is very important and instructive.
Op.Dr.Ahmet UMAY
