MS MULTIPLE SCLEROSIS
Inflammation of the optic nerve (optic neuritis) is an ocular disease which most frequently occurs between 18-45 years, is more common in women and characterized by unilateral, painful loss of vision. It manifests itself in the form of an attack as a result of a compromised immune system. Color perception and brightness is also reduced in the painful eye. In nearly 1/3 of patients, edema forms in front of the optic nerve; in most cases there is retention in the (posterior) parts of the nerve that are close to the brain.
At diagnosis stage, VEP (visually evoked potential) and OCT (Optical Coherence Tomography Scanner) are used at our clinic to examine appearance of the nerve fiber layer and vision area is examined via computer. Brain lesions are investigated through MR imaging of the brain. The number and shape of these lesions (spots) is important in identifying MS risk. MS is a chronic brain disease progressing with attacks.
Optic neuritis may be the first finding of the onset of MS. A disorder of the optic nerve resolves to a large extent in 3-5 weeks. However, optic neuritis attacks may recur. The rate of recurrence within 10 years is 35%. Optic neuritis has a 50% likelihood of occurring at any stage of MS disease and is the first finding of MS in 20% of patients.
The risk of developing MS after optic neuritis is 30% in the first 5-7 years and around 75% in 15-20 years in women.
MS attacks may occur in the form of optic neuritis, double vision and numbness and weakness in the limbs.
Current approaches in the treatment of optic neuritis include IV administration of high-dose cortisone and the use of interferon when the risk of MS is high.
The course of the disease after optic neuritis can be identified through periodic OCT nerve fiber layer analyses. If the OCT nerve fiber layer is becoming thinner, this means that the number of plaques in the brain is increasing. Follow up with OCT and VEP tests is very important and instructive in this disease.
Other Diseases of the Optic Nerve
- Infarction (intraocular injections are possible)
- Toxicity (ethambutol and methyl alcohol toxicities are the most common; treatment is possible if the patient presents without delay)
- Hereditary (a new drug has been developed for Leber optic neuropathy)
- Traumatic (early presentation of the patient is important)