There has clearly been substantial progress in the past 5 years. Of all common neurological disorders, traumatic brain injury (TBI) has the highest incidence and poses a substantial challenge to public health. TBI is increasingly being recognised as a chronic disease with long-term consequences, such as an increased risk of late-onset neurodegeneration. The first Lancet Neurology Commission on TBI, published in 2017, provided expert recommendations to reduce the global burden of TBI, calling for concerted action. The Commission provided the foundation for subsequent research, informed strategies of major funding organisation, and has been used to brief legislators and inform policy.
Treatments are emerging for optic neuropathies, including immunotherapies and genetic therapies. Also reviewed in the Series, a unifying feature in the pathophysiology of hereditary disorders of the optic nerve is mitochondrial dysfunction. Early clinical recognition of optic neuritis is, therefore, important for prognosis and treatment. Also reviewed in this Series, new evidence shows that optic neuritis can frequently indicate autoimmune neurological disorders, including multiple sclerosis and the recently recognised disease categories of aquaporin-4 antibody-associated neuromyelitis optica spectrum disorder and myelin-oligodendrocyte glycoprotein antibody-associated disease.
Multimodality optic nerve imaging-including fundus photography, optical coherence tomography, and MRI-has greatly advanced the diagnosis and follow-up of patients with optic neuropathies.
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This Series provides an update on the clinical, imaging, and laboratory findings that differentiate these disorders, allowing clinicians to focus their diagnostic studies and optimise treatments. Optic neuropathies can reflect a wide range of pathophysiologies, both acquired and inherited.
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