History of Demyelinating Optic Neuropathies: Two Centuries of Progress
Andres Inzunza1, Gabriela Petersen2, Arturo Santos3, Eoin Flanagan4, John Chen4
1Harvard Medical School / Tecnologico de Monterrey / Centro de Retina Medica y Quirurgica / Programa Nacional de Servicio Social en Investigacion, 2Tecnológico de Monterrey, 3Tecnologico de Monterrey / Centro de Retina Medica y Quirurgica, 4Mayo Clinic
Objective:

To trace the history and developments in the field of demyelinating optic neuropathies over the past two centuries.

Background:

Optic neuritis (ON) and related optic neuropathies were initially classified as distinct clinical entities in the 1800s. Demyelinating optic neuropathies have been included in some of the most prominent works of literature and have intrigued many of the most inquisitive minds in the field of medicine. From Charles Dickens' novels to Jean Charcot's discoveries and the introduction of the ophthalmoscope, these conditions have left an indelible mark in the realms of neurology and ophthalmology. 

Design/Methods:

We reviewed the historical archives of the Bruce Fye Library for the History of Medicine at the Mayo Clinic, in addition to utilizing online resources. Our research encompassed gathering information on the individuals, their works, and contributions to the scientific development of demyelinating optic neuropathies. We also examined their backgrounds and assessed the influence of their technologies and publications within this field.

Results:

The discovery of corticosteroids, the implementation of prospective clinical trials, the invention of magnetic resonance imagining (MRI) technology, the development of optical coherence tomography (OCT), and the revolutionary progress in the field of biomarkers have left an indelible mark in this field. Despite the early description of optic neuritis in the context of Multiple Sclerosis (MS) and Neuromyelitis Optica (NMO) over a century ago, definitive confirmation of their distinct nature only emerged at the onset of the new millennium. The application of molecular techniques and cell-based assays (CBAs) have paved the way for the identification of a novel entity: Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD). 

Conclusions:

Our understanding, diagnostic capabilities, and treatment modalities for demyelinating optic neuropathies have undergone significant transformation over the past two decades.

10.1212/WNL.0000000000206431