Optic neuritis is defined as inflammation of the optic nerve. It is one of the causes of acute loss of vision associated with pain. Optic neuritis can be the initial episode for a patient who will subsequently develop multiple sclerosis. (See the images below.) A 43-year-old woman with acute vision loss and eye pain. No prior neurologic symptoms were noted. Axial short tau inversion recovery image demonstrates faint increased signal in the distal left optic nerve. A 43-year-old woman with acute vision loss and eye pain. No prior neurologic symptoms were noted. Axial short tau inversion recovery image demonstrates faint increased signal in the distal left optic nerve. A 35-year-old woman with acute onset of left eye pain and vision decline. Axial fat-suppressed postcontrast T1-weighted image demonstrates enhancement in the intracanalicular portion of the left optic nerve. A 35-year-old woman with acute onset of left eye pain and vision decline. Axial fat-suppressed postcontrast T1-weighted image demonstrates enhancement in the intracanalicular portion of the left optic nerve. The diagnosis of optic neuritis is usually made clinically. Although direct imaging of the optic nerves by magnetic resonance imaging (MRI) is reserved for atypical cases, MRI of the brain yields information that can change management and yield prognostic information in terms of the patient’s future risk for development of multiple sclerosis. As established by the Optic Neuritis Treatment Trial, an abnormal baseline brain MRI is a strong predictor of MS after isolated optic neuritis in adults.1,2,3
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