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Encyclopedia > Optic neuritis
Optic neuritis
Classification & external resources
ICD-10 H46.
ICD-9 377.3
DiseasesDB 9242
MedlinePlus 000741
eMedicine radio/488 
MeSH D009902

Optic neuritis, sometimes called retrobulbar neuritis, is the inflammation of the optic nerve that may cause a complete or partial loss of vision. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // H00-H59 - Diseases of the eye and adnexa (H00-H06) Disorders of eyelid, lacrimal system and orbit (H00) Hordeolum and chalazion (H000) Hordeolum and other deep inflammation of eyelid (H001) Chalazion (H01) Other inflammation of eyelid (H010) Blepharitis (H011) Noninfectious dermatoses of eyelid (H02) Other disorders of eyelid (H020) Entropion... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... Inflammation is the first response of the immune system to infection or irritation and may be referred to as the innate cascade. ... An abscess on the skin, showing the redness and swelling characteristic of inflammation. ... This article is about the anatomical structure. ...

Contents

Causes

The optic nerve comprises axons that emerge from the retina of the eye and carry visual information to the primary visual nuclei, most of which is relayed to the occipital cortex of the brain to be processed into vision. Inflammation of the optic nerve causes loss of vision usually due to the swelling and destruction of the myelin sheath covering the optic nerve. Direct axonal damage may also play a role in nerve destruction in many cases. This article is about the anatomical structure. ... An axon or nerve fiber, is a long, slender projection of a nerve cell, or neuron, that conducts electrical impulses away from the neurons cell body or soma. ... Human eye cross-sectional view. ... A human eye. ... The occipital lobe is the visual processing center of the mammalian brain. ... Italic text // ahh addiing sum spiice iin hurr`` For other uses, see Brain (disambiguation). ... An abscess on the skin, showing the redness and swelling characteristic of inflammation. ... Myelin is an electrically insulating phospholipid layer that surrounds the axons of many neurons. ...


The most common etiology is multiple sclerosis. Up to 50% of patients with MS will develop an episode of optic neuritis, and 20% of the time optic neuritis is the presenting sign of MS . The presence of demyelinating white matter lesions on brain MRI at the time of presentation of optic neuritis is the strongest predictor for developing clinically definite MS. Almost half of the patients with optic neuritis have white matter lesions consistent with multiple sclerosis. At five years follow-up, the overall risk of developing MS is 30%, with or without MRI lesions. Patients with a normal MRI still develop MS (16%), but at a lower rate compared to those patients with three or more MRI lesions (51%). From the other perspective, however, almost half (44%) of patients with any demyelinating lesions on MRI at presentation will not have developed MS ten years later. [1][2] MS can cause a variety of symptoms, including changes in sensation (hypoesthesia), muscle weakness, abnormal muscle spasms, or difficulty to move; difficulties with coordination and balance; problems in speech (Dysarthria) or swallowing (Dysphagia), visual problems (Nystagmus, optic neuritis, or diplopia), fatigue and acute or chronic pain syndromes, bladder and bowel... The mri are a fictional alien species in the Faded Sun Trilogy of C.J. Cherryh. ...


Some other causes include viral-bacterial infections (e.g. herpes zoster), autoimmune disorders (e.g. lupus), chloramphenicol and the inflammation of vessels (vasculitis) nourishing the optic nerve. Ethambutol, an antitubercular drug, can also cause optic neuritis Herpes zoster, colloquially known as shingles, is the reactivation (from the general area of the spinal cord) of varicella zoster virus (VZV, primary infection of which leads to chickenpox), one of the Herpesviridae group, leading to a crop of painful blisters over the area of a dermatome. ... Autoimmune diseases arise from an overactive immune response of the body against substances and tissues normally present in the body. ... Systemic lupus erythematosus (SLE or lupus) is a chronic autoimmune disease that is potentially debilitating and sometimes fatal as the immune system attacks the body’s cells and tissue, resulting in inflammation and tissue damage. ... Chloramphenicol is a bacteriostatic antibiotic originally derived from the bacterium Streptomyces venezuelae, isolated by David Gottlieb, and introduced into clinical practice in 1949. ... In medicine, vasculitis (plural: vasculitides) is a group of diseases featuring inflammation of the wall of blood vessels due to leukocyte migration and resultant damage. ... A bacteriostatic antimycobacterial prescribed to treat Tuberculosis (Mycobacterium). ... For other meanings, see Drug (disambiguation). ...


Symptoms

Major symptoms are sudden loss of vision (partial or complete), or sudden blurred or "foggy" vision, and pain on movement of the affected eye. Many patients with optic neuritis may lose some of their color vision in the affected eye, with colours appearing subtly washed out compared to the other eye. A study found that 92.2% of patients experienced pain, which actually preceded the visual loss in 39.5% of cases.[3] Look up Pain in Wiktionary, the free dictionary. ... Look up vision in Wiktionary, the free dictionary. ...


On medical examination the head of the optic nerve can easily be visualised by an ophthalmoscope; however frequently there is no abnormal appearance of the nerve head in optic neuritis, though it may be swollen in some patients. In many cases, only one eye is affected and patients may not be aware of the loss of color vision until the doctor asks them to close or cover the healthy eye. The ophthalmoscope, invented by Hermann von Helmholtz, is an instrument used to examine the eye. ... This article or section does not cite its references or sources. ...

Example of how optic neuritis affected one eye of a patient with multiple sclerosis
Example of how optic neuritis affected one eye of a patient with multiple sclerosis

Image File history File links Metadata Size of this preview: 800 × 533 pixelsFull resolution (1500 × 1000 pixel, file size: 1. ... Image File history File links Metadata Size of this preview: 800 × 533 pixelsFull resolution (1500 × 1000 pixel, file size: 1. ...

Epidemiology

Optic neuritis typically affects young adults ranging from 18–45 years of age, with a mean age of 30–35 years. There is a strong female predominance. The annual incidence is approximately 5/100,000, with a prevalence estimated to be 115/100,000.[4]


Treatment and Prognosis

In most cases, visual functions return to near normal within 8 to 10 weeks, but they may also advance to a complete and permanent state of visual loss. Therefore, systemic intravenous treatment with corticosteroids, which may quicken the healing of the optic nerve, prevent complete loss of vision, and delay the onset of other symptoms, is often recommended. Intravenous corticosteroids have also been found to reduce the risk of developing MS in the following two years in those patients who have MRI lesions; but dissappearing this effect at the third year of follow up.[5] In physiology, corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. ... The mri are a fictional alien species in the Faded Sun Trilogy of C.J. Cherryh. ...


Paradoxically it has been demonstrated that oral administration of corticosteroids in this situation may lead to more recurrent attacks than in non-treated patients (though oral steroids are generally prescribed after the intravenous course, to wean the patient off the medication). This effect of corticosteroids seems to be limited to optic neuritis and has not been observed in other diseases treated with corticosteroids.[6]


Very occasionally, if there is concomitant increased intracranial pressure the sheath around the optic nerve may be cut to decrease the pressure. Intracranial pressure, (ICP), is the pressure exerted by the cranium on the brain tissue, cerebrospinal fluid (CSF), and the brains circulating blood volume. ...


When optic neuritis is associated with MRI lesions suggestive of multiple sclerosis (MS) then general immunosuppressive therapy for MS is most often prescribed (IV methylprednisolone may shorten attacks; oral prednisone may increase relapse rate). Immunosuppression is the medical suppression of the immune system. ...


References

  1. ^ Beck RW, Trobe JD (1995). "What we have learned from the Optic Neuritis Treatment Trial". Ophthalmology 102 (10): 1504-8. PMID 9097798. 
  2. ^ (2001) "The 5-year risk of MS after optic neuritis: experience of the optic neuritis treatment trial. 1997". Neurology 57 (12 Suppl 5): S36-45. PMID 11902594. 
  3. ^ Boomer JA, Siatkowski RM (2003). "Optic neuritis in adults and children". Seminars in ophthalmology 18 (4): 174-80. PMID 15513003. 
  4. ^ Rodriguez M, Siva A, Cross SA, O'Brien PC, Kurland LT (1995). "Optic neuritis: a population-based study in Olmsted County, Minnesota". Neurology 45 (2): 244-50. PMID 7854520. 
  5. ^ Beck RW, Cleary PA, Trobe JD, Kaufman DI, Kupersmith MJ, Paty DW, Brown CH (1993). "The effect of corticosteroids for acute optic neuritis on the subsequent development of multiple sclerosis. The Optic Neuritis Study Group". N. Engl. J. Med. 329 (24): 1764-9. PMID 8232485. 
  6. ^ Beck RW, Cleary PA, Anderson MM, Keltner JL, Shults WT, Kaufman DI, Buckley EG, Corbett JJ, Kupersmith MJ, Miller NR (1992). "A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis. The Optic Neuritis Study Group". N. Engl. J. Med. 326 (9): 581-8. PMID 1734247. 

  Results from FactBites:
 
Optic neuritis - Wikipedia, the free encyclopedia (424 words)
Optic [[neuritis](or retrobulbar neuritis) is the inflammation of the optic nerve that may cause a complete or partial loss of vision.
The optic nerve comprises axons that emerge from the retina of the eye and carry visual information to the primary visual nuclei, most of which is relayed to the occipital cortex of the brain to be processed into vision.
Optic neuritis is generally diagnosed and comanaged by neurologists and ophthalmologists.
  More results at FactBites »

 
 

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