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ReviewJournal of neuroimmunology · 2026

Clinical features, imaging findings, and treatment outcomes of optic neuritis associated with anti-CRMP5 antibodies: a systematic review.

Rafael Martins Themoteo, Yang Han Yu, Joana Laura Aihara Barbosa … Guilherme Diogo Silva

OphthalmologyReview

Lack of tumor response to cancer treatment linked to much higher mortality in this condition.

Clinical features, imaging findings, and treatment outcomes of optic neuritis associated with anti-CRMP5 antibodies: a systematic review.

Rafael Martins Themoteo … Guilherme Diogo Silva

Journal of neuroimmunology · 2026

Background

Anti-CRMP5/CV2 antibody disease is a rare cause of optic neuritis, therefore the clinical findings, results of neuroimaging, CSF studies and treatment outcomes have been described in case reports or small case series.

Methods

Here, we performed a systematic review including all published cases of optic neuritis with positive anti-CRMP5/CV2 antibodies.

n = 32 patients

Results

when treatment failed to shrink the tumor, patients almost always died

88.9%

Mortality if no tumor

32.1%

Overall mortality

More results

Median age was 67 years (60-71); 87.1% of patients had clinically symptomatic bilateral optic neuritis, with 64% having a visual acuity worse than 20/200 and ocular pain was uncommon (4.2%).

An associated malignancy was identified in 90.6% of cases, most commonly small-cell lung carcinoma (more than 70%) and breast (5%).

More results

Optic disc edema occurred in 83.9%, frequently with vitreous (70.8%) and retinal (35%) inflammation.

Orbit MRI was normal in 57.1% of cases, but CSF almost universally showed pleocytosis.

“

Conclusion

Further investigation into the mechanisms by which CD8+ cytotoxic T-cell recruitment and activation in the pre-laminar optic nerve is essential to develop targeted therapies that can improve visual outcomes.

Post

Clinical features, imaging findings, and treatment outcomes of optic neuritis associated with anti-CRMP5 antibodies: a systematic review.

Lack of tumor response to cancer treatment linked to much higher mortality in this condition.

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