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Optic neuritis: the eye as a window to the brain.

Jenkins, TM; Toosy, AT; (2016) Optic neuritis: the eye as a window to the brain. Curr Opin Neurol , 30 (1) pp. 61-66. 10.1097/WCO.0000000000000414. Green open access

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Abstract

PURPOSE OF REVIEW: Acute optic neuritis is a common clinical problem, requiring a structured assessment to guide management and prevent visual loss. The optic nerve is the most accessible part of the central nervous system, so optic neuritis also represents an important paradigm to help decipher mechanisms of damage and recovery in the central nervous system. Important developments include the advent of optical coherence tomography as a biomarker of central nervous system axonal loss, the discovery of new pathological antibodies, notably against aquaporin-4 and, more recently, myelin oligodendrocyte protein, and emerging evidence for sodium channel blockade as a novel therapeutic approach to address energy failure in neuroinflammatory disease. RECENT FINDINGS: We will present a practical approach to assessment of optic neuritis, highlighting the role of optical coherence tomography, when to test for new antibodies and the results of recent trials of sodium channel blockers. SUMMARY: Optic neuritis remains a clinical diagnosis; increasingly optical coherence tomography is a key ancillary investigation. Patients with 'typical' optic neuritis, commonly a first presentation of multiple sclerosis, must be distinguished from 'atypical' optic neuritis, who require testing for new pathological antibodies and require more aggressive-targeted treatment. Sodium channel blockade is an emerging and novel potential therapeutic pathway in neuroinflammatory disease.

Type: Article
Title: Optic neuritis: the eye as a window to the brain.
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/WCO.0000000000000414
Publisher version: http://dx.doi.org/10.1097/WCO.0000000000000414
Language: English
Additional information: Copyright © 2016 Wolters Kluwer Health, Inc. This is the accepted manuscript version of this article published in Current Opinion in Neurology; the final published version of record can be found at http://dx.doi.org/10.1097/WCO.0000000000000414
Keywords: Multiple sclerosis, neuromyelitis optica, optic neuritis
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Neuroinflammation
URI: https://discovery.ucl.ac.uk/id/eprint/1533202
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