Pathogenesis (development of disease)
Typical optic neuritis occurs either in the setting of multiple sclerosis (majority of cases) or idiopathically (with no apparent cause).
It involves a T-cell-, B-cell-, and microglia-mediated immune reaction against optic nerve tissue.
Atypical optic neuritis may result from the following disease mechanisms:
- As a manifestation of an autoimmune disease, eg.
- Chronic relapsing inflammatory optic neuropathy (CRION).
- Lupus erythematosus
- Neuromyelitis optica (NMO; synonyms: Devic syndrome; neuromyelitis optica spectrum disorders (NMOSD)) Neuromyelitis optica (NMO; synonyms: Devic syndrome; neuromyelitis optica spectrum disorders (NMOSD) – atypical optic neuritis belonging to the group of rare autoimmune inflammatory diseases of the central nervous system; occurrence in 1-3% of optic neuritis.
- Sarcoidosis – granulomatous inflammation, which is considered an inflammatory multisystem disease, the cause of which is still unclear.
- Postinfectious (after infection) or postvacinal (after vaccination).
- infectious/parainfectious
- Lyme disease – infectious disease caused by the bacterium Borrelia burgdorferi.
- Syphilis (lues)/sexual disease
- Neuroretinitis – spread of inflammation from the optic nerve to the retina; marked papilledema and involvement of the macula (“point of sharpest vision”; yellow spot); etiology: possibly a bacterially triggered immune reaction?; e.g., by Bartonella.
Etiology (causes)
Biographical causes
- Gender – Women are affected in more than 70% of cases.
Disease-related causes
- Atypical optic neuritis (see above under pathogenesis).
- Multiple sclerosis (MS) (= typical optic neuritis).
Medication
- Interferon alfa-2a, peginterferon alfa-2a