Table 1

Summary of tests to be considered for a contemporary state-of-the art Optic Neuritis Treatment Trial

ClinicalPatient reportedImagingLaboratoryOther
HCVAQoLFunduscopyMOG*ERG†
LCVAPROMsOCT‡AQP4*VEP†
Colour visionService requirementsOCTA§ANAPerimetry
PulfrichEase of service accessFAF†Neurofilament¶Pharmacokinetics
RAPD**SatisfactionMRI††Sample storage
  • We strongly recommend storage of research blood samples as new biomarkers continue to be discovered.

  • *Cell-based assays recommended for MOG and AQP4.

  • †On clinical grounds, in selected cases, FAF/ERG/VEP will be very helpful. We do not think this needs to be done routinely in every patient.

  • ‡We recommend a macular volume scan of sufficient quality to permit layer segmentation and recognition of MMO and a peripapillary ring scan. Adherence to validated OCT quality control criteria and reporting guidelines is recommended.22,61 There should be a central reading centre.64

  • §Same macular area as by OCT; optic disc only if device capable to reliably image.

  • ¶Neurofilament light and heavy chains should be quantified using a sensitive and validated immunoassay; batch analyses in single laboratory strongly recommended.

  • **Quantitative, pupillometric assessment of the RAPD.29 [68]

  • ††MRI sequences have been detailed in a consensus protocol.6 This protocol takes ~10 min for the optic nerve, ~20 min for the brain and, if required, an additional ~15 min for the spinal cord. Inclusion of research sequences such as diffusion tensor imaging will require more time.

  • ANA, antinuclear antibodies; AQP4, aquaporin 4; ERG, electroretinogram; FAF, fluorescein angiography; HCVA, high-contrast visual acuity; LCVA, low-contrast visual acuity; MOG, myelin oligodendrocyte; OCT, optical coherence tomography; OCTA, optical coherence tomography angiography; PROM, patient-reported outcome measure; QoL, quality of life; RAPD, relative afferent pupillary deficit; VEP, visual evoked potentials.