Optic perineuritis (OPN) involves inflammation of the fibrovascular sheath that surrounds the optic nerve. It is associated with a number of clinical findings.
Clinical features of optic perneuritis (OPN):
(1) blurring of vision
(2) visual loss often with preservation of central vision (paracentral or arcuate field defects)
(3) ocular pain
(4) disc edema
(5) dramatic response to corticosteroids
The diagnosis is often made based on imaging studies with the "donut" sign (contrast-enhancement around the intra-orbital optic nerve but sparing of the optic nerve) on fat-suppressed coronal MRI. It may referred to a hyperintense lesion around the optic nerve on T2-weighted imaging.
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