Optic neuritis (synonyms: Neuritis nervi optici; Retrobulbar neuritis; ICD-10-GM H46: Neuritis nervi optici) is an inflammation of the optic nerve. The disease is usually associated with unilateral eye movement pain and subacute (“moderately rapid”) visual loss (visual deterioration).
Approximately 50% of patients with typical optic neuritis develop multiple sclerosis within 15 years.
Sex ratio: Women are affected in more than 70% of cases.
Peak incidence: The disease occurs predominantly between the ages of 20 and 40 years; however, it is possible at any age.The average age is 36 years; under 18 and over 50 years of age, the disease is rare.
The incidence (frequency of new cases) is about 5 cases per 100,000 inhabitants per year (in Germany).
Course and prognosis: The visual disturbances are usually preceded by pain in the eye region, which lasts a few days to weeks and occurs emphatically during eye movements (= eye movement pain; 92 % of patients), followed by visual impairment (visual deterioration): increase of the often unilateral visual deterioration over days, with flashes of light (photopsia) often provoked by eye movements; low point within one to two weeks – thereafter improvement in 95 % of cases. Approximately 60% of patients achieve normal vision after 2 months.
Note: In severe cases, neuromyelitis optica (NMO; synonyms: Devic syndrome; neuromyelitis optica spectrum disorders (NMOSD); atypical optic neuritis, which belongs to the group of rare autoimmune inflammatory diseases of the central nervous system). Macular involvement (“point of sharpest vision”; yellow spot) must be considered as an indication of neuroretinitis (spread of inflammation from the optic nerve to the retina: Vasculitis of the arterioles/vascular inflammation of the small arteries of the optic disc (area of the retina where the retinal nerve fibers gather and form the optic nerve after leaving the eyeball) with submacularly disseminated transsudate/secreted fluid).
