Diagnosing optic neuritis can be challenging, particularly when patients present with atypical symptoms or inconclusive imaging results.

In this keynote, Axel Petzold introduces a practical, step-by-step approach to diagnosing and classifying optic neuritis. Through real-world clinical cases, he explains how symptoms such as eye pain and visual loss can be assessed alongside optical coherence tomography (OCT), magnetic resonance imaging (MRI), and antibody testing.

The session explores the diagnostic differences between optic neuritis associated with multiple sclerosis (MS), aquaporin-4 antibodies (AQP4), and myelin oligodendrocyte glycoprotein antibodies (MOG). It also highlights the importance of recognising cases in which MRI findings are normal despite clear clinical evidence of optic nerve inflammation.

Finally, the strengths and limitations of current diagnostic criteria are discussed, including the recognition of primary progressive optic neuritis and the importance of careful clinical interpretation.

Key Insights from the Lecture:

• Applying diagnostic criteria: Understand a structured approach to diagnosing and classifying optic neuritis across different clinical presentations.
• Combining clinical and imaging findings: Explore how OCT, MRI, and biomarkers complement clinical examination.
• Recognising different disease presentations: Learn to distinguish optic neuritis associated with MS, AQP4 antibodies, and MOG antibodies.
• Understanding diagnostic limitations: Discover why normal MRI findings do not necessarily exclude optic neuritis.
• Learning from clinical cases: Explore practical diagnostic challenges, including bilateral visual loss and primary progressive optic neuritis.

“Clinical Aspects of Optic Neuritis”

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Summary

Axel Petzold explores a practical approach to diagnosing and classifying optic neuritis using the latest diagnostic criteria. Through real-world clinical cases, he demonstrates how clinical examination, optical coherence tomography (OCT), MRI, and biomarkers can help distinguish optic neuritis associated with multiple sclerosis (MS), MOGAD, and NMOSD. He also highlights diagnostic challenges, including normal MRI findings and the recognition of primary progressive optic neuritis.

About the Meeting

This presentation was recorded during the Annual MS Meeting 2026, held on 13 June 2026 at the Irish College in Leuven, Belgium.

Organized by the Belgian Study Group for Multiple Sclerosis (BSGMS) and Paradigms Foundation, the meeting focused on Optic Neuritis Unveiled: Clinical and Imaging Perspectives, bringing together experts to discuss advances in diagnosis, imaging, and clinical management.

About the speaker:

Axel Petzold is a neurologist and neuro-ophthalmology specialist whose clinical and research work focuses on optic neuritis, multiple sclerosis, and neuroaxonal damage. He has contributed to the development of international diagnostic criteria for optic neuritis and the use of optical coherence tomography (OCT) in neurological disorders. His work bridges clinical neurology, ophthalmology, and advanced imaging to improve the diagnosis and understanding of inflammatory optic nerve diseases.

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