Early Criteria for the Diagnosis of Optic Neuritis in the Setting of Davic’s Disease

Background. Optic neuritis is the first symptom of Davic’s disease in more than half of cases. Differential diagnosis of optic neuritis in the clinical practice is complicated due to the uniformity of the clinical pattern of inflammatory and demyelinating optic neuritis in the early stages of the disease. The approach to the management of patients with Davic’s disease is varied and requires a precise differentiation at the initial stages of its development. Purpose. To determine early objective criteria for diagnosing the optic neuritis in the setting of Davic’s disease. Materials and methods. We observed 31 patients (51 eyes), while the control group consisted of 12 healthy individuals (12 eyes). Research methods were both standard ophthalmic and specialized – optical coherence tomography, visual evoked potential test, magnetic resonance imaging of the brain and spinal cord. Results. In patients with optic neuritis in the setting of Davic’s disease, optical coherence tomography revealed a smaller area of the optic nerve disc and neuroretinal belt as well as a decrease in macular volume and macular thickness. A reduction of the retinal ganglion cell complex and the inner plexiform layer was also revealed. Conclusion. At the initial stages of Davic’s disease, it is necessary to conduct optical coherence tomography of the retina, perform visual evoked potential test as well as magnetic resonance imaging of the brain and spinal cord. Appropriate treatment at an early stage of the disease can reduce the rates of axonal degeneration and optic disc atrophy development.

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