Mechanism: Many immune-based disorders improve during pregnancy, only to relapse after delivery. This may be related to decreased release of cytokines.
Patient selection: woman in the postpartum period
Clinical features:
(1) onset of pain in the eye with eye movement followed by visual loss with visual field defects
(2) history of demyelinating disease, or subsequent development of a demyelinating disease
(3) exclusion of other conditions affecting vision (pituitary adenoma, Sheehan's syndrome, amniotic fluid embolization, DIC, retinopathy of eclampsia, cortical ischemic event, autoimmune disease, infection)
(4) pallor and/or edema of the optic disc may be present (papillitis); this is absent in retrobulbar optic neuritis
(5) positive response to prednisone therapy
MRI will show the inflammation of the optic nerve. It may also so demyelinating lesions in the brain.
