Differential Diagnosis for Multiple Sclerosis-related Optic Neuritis.

PURPOSE: To analyze clinical features and main causes of multiple sclerosis-related optic neuritis (MS-ON), providing evidence for the differential diagnosis of MS-ON.

METHODS: Clinical data were collected from 527 patients, 123 males and 404 females, diagnosed with MS-ON between June 2008 and June 2013. Visual acuity, optometry, visual field, slit-lamp microscopy, indirect ophthalmoscopy (20D), optical coherence tomography (OCT) and magnetic resonance imaging (MRI) were performed. Venous blood was sampled for detection of autoimmune antibodies and Aquaporin (AQP- 4).

RESULTS: Fifty nine cases were diagnosed with neuromyelitis optica-related optic neuritis (NMO-ON), 27 Sjogren's syndrome-related optic neuropathy, 22 tumors, 21 anterior ischemic optic neuropathy, 15 radiation-induced optic neuropathy, 14 optic neuropathy-related infection, 17 genetic eye diseases and 10 open angle glaucoma. Among 168 MS-ON patients undergoing optic nerve MRI,90 cases (53.57%) had a lesion < 15 mm in size, 15-30 mm in 76 (45.24%) and > 30 mm in two (1.19%).

CONCLUSION: MS-ON is more commonly misdiagnosed with NMO-ON and Sjogren's syndrome, when compared to optic neuropathy, tumors and ischemic optic neuropathy.