Real-world application of the 2022 diagnostic criteria for first-ever episode of optic neuritis

• Published in: Journal of neuroimmunology Vol. 381; p. 578140
• Main Authors: Terrim, Sara, Silva, Guilherme Diogo, de Sá e Benevides Falcao, Fernando Cavalcanti, dos Reis Pereira, Clarissa, de Souza Andrade Benassi, Thais, Fortini, Ida, Gonçalves, Marcia Rubia Rodrigues, Castro, Luiz Henrique Martins, Comerlatti, Luiz Roberto, de Medeiros Rimkus, Carolina, Adoni, Tarso, Pereira, Samira Luisa Apostolos, Monteiro, Mário Luiz, Callegaro, Dagoberto
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15.08.2023
• Subjects: Multiple sclerosis; Optic neuritis; Optic neuritis classification; Optic neuritis diagnostic criteria; Optic neuropathy; Optic neuritis classification; Optic neuritis diagnostic criteria; Multiple sclerosis; Optic neuropathy; Optic neuritis
• ISSN: 0165-5728; 1872-8421
• DOI: 10.1016/j.jneuroim.2023.578140

Optic neuritis (ON) admits diverse differential diagnoses. Petzold proposed diagnostic criteria for ON in 2022, although real-world application of these criteria is missing. We conducted a retrospective review of patients with ON. We classified patients into definite or possible ON, and into groups A (typical neuritis), B (painless), or C (binocular) and estimated the frequency of etiologies for each group. We included 77 patients, with 62% definite and 38% possible ON. CRION and NMOSD-AQP4 negative-ON were less commonly seen in definite ON. Application of the 2022 criteria revealed a lower-than-expected frequency of definite ON, particularly for seronegative non-MS causes. •Optic neuritis diagnostic criteria 2022 may have higher sensitivity for typical ON.•Non-MS seronegative ON may be underrepresented by diagnostic criteria.•Access to biomarkers may be an obstacle for diagnosis of ON in low-income scenarios.