Autoimmune Optic Neuropathy (AON)

Clinical features:

(1) one or more episodes of reduced visual acuity to vision loss, which may affect one or both eyes

(2) some evidence of an autoimmune disease

(2a) systemic autoimmune disorder

(2b) isolated involvement of the optic nerve with evidence of an autoantibody

(3) enhancement of the optic nerve on MRI

(4) dramatic response to corticosteroids or immunosuppression

Ischemic optic neuropathy may occur as a consequence of autoimmune vasculitis. Visual loss may be permanent.

Differential diagnosis:

(1) autoimmune encephalitis

(2) autoimmune disease affecting the globe

(3) other causes of optic neuropathy such as multiple sclerosis