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Management of Optic Neuritis - Episode 8

Optic Neuritis Take-Home Message

Robert C. Sergott, MD: Rod, what are your take-home messages, in a sentence or 2, for practicing neurologists, ophthalmologists, and neuro-ophthalmologists about MS [multiple sclerosis] in the year 2020?

Rod Foroozan, MD: I think the biggest factor is I like to be a splitter now, and that is to think about inflammatory optic neuropathy not as 1 diagnosis but just a marker of several conditions. Consider NMO [neuromyelitis optica], consider MOG. If you’re not ordering the blood test on everyone, that’s probably OK. But my approach is as soon as I see anything atypical—and that may be lack of visual recovery, early visual recovery with treatment, simultaneous bilaterality, an atypical age group at presentation like a child, an older adult—consider these other conditions before pigeonholing yourself and telling yourself the patient has MS.

Robert C. Sergott, MD: That’s excellent. I would also like to stress the multidisciplinary team approach to this. I always work with a multiple sclerosis specialist at Jefferson Memorial Hospital. I always want to work with a general neurologist and a general ophthalmologist close to where the patient lives. I’m very cautious of diagnosing recurrent optic neuritis in an MS patient at age 42 because it’s likely they need glasses and bifocals. The symptom of blurred vision is not always optic neuritis, and we have to be cautious about that. I would take it 1 step further: what Rod said is that if we do this program again in 18 months or maybe even 12 months, we’ll have some new and different messages for you.

I want to thank you for joining this NeurologyLive® program titled the “Management of Optic Neuritis.” Thank you very much, Rod.

Rod Foroozan, MD: Thank you.