Which statement best describes diagnosing optic neuritis with imaging?

Which statement best describes diagnosing optic neuritis with imaging?

• A. Electroretinogram must be abnormal
• B. Diagnosis relies solely on imaging findings
• C. MRI +/- CSF tap can support the diagnosis
• D. Intraocular pressure elevation confirms diagnosis

Answer: (C)

Imaging helps confirm optic neuritis by showing signs of optic nerve inflammation, and doing an MRI of the orbits with contrast can reveal optic nerve enhancement during active inflammation. Extending the MRI to include brain imaging can also reveal demyelinating lesions typical of multiple sclerosis, which influences both diagnosis and prognosis. A lumbar puncture with CSF analysis adds further support by detecting oligoclonal bands and an elevated IgG index, which point to a demyelinating process underlying the optic neuritis. Taken together, MRI findings plus CSF results provide the strongest supporting evidence for the diagnosis, especially in the context of new vision loss with eye pain on movement and decreased visual acuity. It’s not necessary to rely solely on imaging, because clinical features and CSF data contribute essential context. Conversely, an electroretinogram is not required to diagnose optic neuritis, imaging alone is not definitive, and elevated intraocular pressure points to glaucoma rather than optic neuritis.

Imaging helps confirm optic neuritis by showing signs of optic nerve inflammation, and doing an MRI of the orbits with contrast can reveal optic nerve enhancement during active inflammation. Extending the MRI to include brain imaging can also reveal demyelinating lesions typical of multiple sclerosis, which influences both diagnosis and prognosis. A lumbar puncture with CSF analysis adds further support by detecting oligoclonal bands and an elevated IgG index, which point to a demyelinating process underlying the optic neuritis. Taken together, MRI findings plus CSF results provide the strongest supporting evidence for the diagnosis, especially in the context of new vision loss with eye pain on movement and decreased visual acuity. It’s not necessary to rely solely on imaging, because clinical features and CSF data contribute essential context. Conversely, an electroretinogram is not required to diagnose optic neuritis, imaging alone is not definitive, and elevated intraocular pressure points to glaucoma rather than optic neuritis.