There is no consensus regarding the classification of optic neuritis, and precise diagnostic criteria are not available. This reality means that the diagnosis of disorders that have optic neuritis as the first manifestation can be challenging. Accurate diagnosis of optic neuritis at presentation can facilitate the timely treatment of individuals with multiple sclerosis, neuromyelitis optica spectrum disorder, or myelin oligodendrocyte glycoprotein antibody-associated disease. Epidemiological data show that, cumulatively, optic neuritis is most frequently caused by many conditions other than multiple sclerosis. Worldwide, the cause and management of optic neuritis varies with geographical location, treatment availability, and ethnic background. We have developed diagnostic criteria for optic neuritis and a classification of optic neuritis subgroups. Our diagnostic criteria are based on clinical features that permit a diagnosis of possible optic neuritis; further paraclinical tests, utilising brain, orbital, and retinal imaging, together with antibody and other protein biomarker data, can lead to a diagnosis of definite optic neuritis. Paraclinical tests can also be applied retrospectively on stored samples and historical brain or retinal scans, which will be useful for future validation studies. Our criteria have the potential to reduce the risk of misdiagnosis, provide information on optic neuritis disease course that can guide future treatment trial design, and enable physicians to judge the likelihood of a need for long-term pharmacological management, which might differ according to optic neuritis subgroups.

关于视神经炎的分类没有达成共识，也没有准确的诊断标准。这一现实意味着以视神经炎为首发表现的疾病的诊断可能具有挑战性。就诊时准确诊断视神经炎有助于及时治疗多发性硬化症、视神经脊髓炎谱系障碍或髓鞘少突胶质细胞糖蛋白抗体相关疾病患者。流行病学数据显示，视神经炎最常由多发性硬化症以外的许多病症引起。在世界范围内，视神经炎的病因和治疗因地理位置、治疗可用性和种族背景而异。我们制定了视神经炎的诊断标准和视神经炎亚组分类。我们的诊断标准基于允许诊断可能的视神经炎的临床特征；利用大脑、眼眶和视网膜成像以及抗体和其他蛋白质生物标志物数据进行进一步的临床旁测试，可以诊断出明确的视神经炎。临床旁测试也可以回顾性地应用于存储的样本和历史大脑或视网膜扫描，这将有助于未来的验证研究。我们的标准有可能降低误诊的风险，提供可以指导未来治疗试验设计的视神经炎病程信息，并使医生能够判断需要长期药物治疗的可能性，这可能因视神经而异神经炎亚群。