Optic Neuritis in Children

Abstract

Optic neuritis is a primary inflammation of the optic nervethat affects Caucasian population of often during spring. It is caused by peripheral activation of T-cells that cross the blood brain barrier causing delayed type IV of hypersensitivity reaction. It can appear as an isolated condition or associated to a variety of systemic autoimmune disorders as ADEM and MS but associated more with ADEM rather than MS. Parainfectious optic neuritis is the most common form in children,it may also occur following vaccinations. The typical presentation of optic neuritis is a sudden and unilateral visual loss, periocular pain associated with eye movement, visual field defect and relative afferent pupillary defect (RAPD). Examination of suspected cases maybe normal in retrobulbar cases or shows optic disc swelling and there may be macular edema which diagnose neuroretinitis rather than ON. Diagnosis must be confirmed by OCT which shows thinning in RNFL,VEP and MRI which is the technique of choice after a diagnosis of optic neuritis and should be performed preferably during the following two weeks after the initial symptoms to show risk of developing multiple sclerosis. Also laboratory studies play an important role in diagnosis of On by CSF examination and NMO antibody in serum.