The Treatment of Acute Optic Neuritis

Semin Ophthalmol. 2023 Aug;38(6):511-514. doi: 10.1080/08820538.2023.2211662. Epub 2023 May 10.


Despite the high incidence of optic neuritis (ON), and the growing number of therapeutic options for the long-term treatment of diseases associated with ON including multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD) and MOG antibody associated disease (MOGAD), there are still only limited therapeutic options for treating an acute event of optic neuritis. These include steroids, plasma exchange (PLEX) and intravenous immunoglobulin (IVIG). High-dose steroids remain the mainstay of acute treatment. However, evidence is emerging that when optic neuritis is accompanied with certain atypical features that suggest a more unfavorable outcome this mandates special consideration such as early addition of other therapeutic agents or tapering the steroid very slowly. This review will distinguish between typical and atypical neuritis and discuss acute treatment options.

Keywords: Atypical optic neuritis; optic neuritis; optic neuropathy; typical optic neuritis.

Publication types

  • Review

MeSH terms

  • Autoantibodies
  • Humans
  • Multiple Sclerosis* / complications
  • Multiple Sclerosis* / therapy
  • Myelin-Oligodendrocyte Glycoprotein
  • Neuromyelitis Optica* / diagnosis
  • Neuromyelitis Optica* / therapy
  • Optic Neuritis* / diagnosis
  • Optic Neuritis* / therapy


  • Myelin-Oligodendrocyte Glycoprotein
  • Autoantibodies