Pediatric Optic Neuritis

  • Etiology: Infectious, para-infectious – ADEM, multiple sclerosis – 1/3 present with optic neuritis
  • Imaging MRI:
    — Commonly bilateral
    — T1WI: Hypointense optic nerve
    — T1WI post contrast: Enhancing optic nerve
    — T2WI: Hyperintense optic nerve
  • DDX:
  • Complications:
  • Treatment:
  • Clinical:
    — More commonly associated with disc swelling
    — Confused with papilledema and clinical distinction from papilledema is optic neuritis has decreased vision and anterior vitreous cells

Radiology Cases of Optic Neuritis

MRI of optic neuritis
Coronal FLAIR MRI without contrast of the orbits (above) shows bright signal in an enlarged right optic nerve. Axial (below lower left) and coronal (below lower right) T1 MRI with contrast of the orbits shows intense enhancement in an enlarged right optic nerve.