In this clinical case lecture, Vincent van Pesch examines three cases of severe optic neuritis in young patients with Multiple Sclerosis (MS), illustrating the diversity of clinical presentations and visual outcomes.

Key Insights from the Lecture:

• Recognise atypical presentations: Severe visual loss, optic disc edema, uveitis and retinal periphlebitis can occur in MS-related optic neuritis.
• Strengthen differential diagnosis: MRI, optical coherence tomography (OCT), cerebrospinal fluid analysis and antibody testing help distinguish MS from NMOSD and MOGAD.
• Consider early treatment escalation: Plasma exchange may be considered in severe cases with insufficient response to corticosteroids.
• Monitor visual recovery: Outcomes vary considerably, and visual improvement may continue for several months after the acute episode.

“Severe Optic Neuritis in Multiple Sclerosis: Diagnostic Challenges and Clinical Outcomes”

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Summary

Vincent van Pesch highlights the importance of comprehensive diagnostic assessment, including MRI, optical coherence tomography (OCT), cerebrospinal fluid analysis and antibody testing, to distinguish between these conditions. He also discusses the role of early plasma exchange in patients with insufficient response to corticosteroids and emphasises the variability of visual recovery, which may continue for several months after the acute episode

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:

Prof. Vincent van Pesch is a neurologist specialising in Multiple Sclerosis (MS) and neuroimmunology at Cliniques universitaires Saint-Luc, Brussels, Belgium. He is affiliated with UCLouvain and is involved in clinical research and education focused on inflammatory disorders of the central nervous system, including MS and related conditions.

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