Navigating the Diagnostic Overlap: Why 24 Percent of Patients Meeting Minimal MS Criteria for Optic Neuritis Require Antibody Testing

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A recent multicenter retrospective study published in Neurology found that among patients presenting with inaugural acute optic neuritis who met the minimal 2017 McDonald criteria for multiple sclerosis (MS), 24% were ultimately diagnosed with an alternative antibody-mediated condition.

The study identified specific orbital MRI markers, including longitudinally extensive lesions, bilateral involvement, and optic perineuritis, as being 100% sensitive for non-MS diagnoses in this cohort.