Open AccessWorking up a child with demyelinating optic neuritis: Striking a balance!
Author(s) -
Virender Sachdeva,
Ramesh Kekunnaya
Publication year - 2021
Publication title -
oman journal of ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.306
H-Index - 16
eISSN - 0974-7842
pISSN - 0974-620X
DOI - 10.4103/ojo.ojo_105_21
Subject(s) - optic neuritis , medicine , neuromyelitis optica , myelin oligodendrocyte glycoprotein , neuroimaging , acute disseminated encephalomyelitis , multiple sclerosis , etiology , balance (ability) , pediatrics , intensive care medicine , pathology , immunology , experimental autoimmune encephalomyelitis , physical medicine and rehabilitation , psychiatry
Pediatric optic neuritis (PON) is one of the commonest causes of acute vision loss in children. Although it might often be postinfectious or postvaccination, recent understanding and available evidence suggest that it can be the first manifestation of a neuro-inflammatory syndrome such as multiple sclerosis, neuromyelitis optica spectrum disorder, acute disseminated encephalomyelitis or myelin oligodendrocyte glycoprotein associated optic neuritis. Therefore, neuroimaging, serological testing, cerebrospinal fluid analysis, testing for various systemic autoimmune conditions become a part of the workup. However, this can be exhaustive and expensive, especially in countries with limited access to health insurance. Many recent studies suggest that neuroimaging and few clinical features can provide clues to the underlying etiology. However, serological tests can provide a confirmatory evidence. Therefore, in this mini-review, we propose a balanced approach to the evaluation of PON, based on the available literature emanating in the last decade.