An Australian ophthalmologist is among a group of researchers behind a new study which identifies how to diagnose optic neuritis, a common cause of vision loss.
Associate Professor Clare Fraser from Save Sight Institute in Sydney, and London-based colleagues Dr Axel Petzold and Professor Gordon Plant, have developed diagnostic criteria that will help inform treatment options for patients with the condition.
‘Diagnosis and classification of optic neuritis’ was published in Lancet Neurology in December 2022.
Prior to the publication of their study, there has been no consensus on how to diagnose optic neuritis – inflammation in the optic nerve – making it challenging to provide timely treatment for conditions in which it is the first symptom.
The research team recruited over 100 specialists from 60 countries to assess real life clinical scenarios. This enabled them to develop diagnostic criteria outlining clinical features that indicate possible optic neuritis. Further tests, including brain, orbital, and retinal imaging, together with biomarker data, could then be used to confirm a definite diagnosis of the condition.
“This is an important international collaboration, which expands our understanding and classification of all types of optic neuritis across the world,” Fraser said.
“We are hopeful that the criteria we have developed will lead to a consensus on how to design treatment trials for optic neuritis in the future.”
The cause and management of optic neuritis varies with geographical location, treatment availability and ethnic background. Historically, clinical research on optic neuritis has been carried out in Europe and North America. Therefore, reports on diagnosis and management have been dominated by the disease profile of this demographic.
In the study, the researchers achieved a 95% expert consensus through a Delphi process to categorise the links between optic neuritis and other antibody mediated disorders including syndromes such as Neuromyelitis Optica, or Myelin Oligodendrocyte Glycoprotein Antibody-associated Disease, which are more common in patients of African and Asian origin.
Petzold, from UCL Queen Square Institute of Neurology in London, said they hope their classification will lead to the identification of yet more immunological causes of optic neuritis and ensure uniformity in identifying sub-types of optic neuritis.
The criteria developed by the researchers will reduce the risk of misdiagnosis and will be useful for informing treatment options. For example, the likelihood of a patient needing long-term pharmacological management may differ according to their subgroups of optic neuritis.
More reading
Aussie professor’s gene therapy technique improved ‘optic nerve activity’
Unilateral glaucoma or historic non-arteritic anterior ischaemic optic neuropathy (NAION)?
Neuropathic pain in the eye – A/Prof Alex Hui
