What has caused the damage to my optic nerve?

Here is My Question:
After being diagnosed with Open Angle Glaucoma for 10 years, I've recently found out that I do not have it. There is a situation with my optic nerves, that a Glaucoma Specialist seems to think it's an affect from multiple sclerosis. I was told years ago that I had MS but never sought treatment for it. I went to a neurologist and he scheduled an MRI. He also did blood work. I couldn't proceed with the MRI, so I'm waiting to obtain an appointment with open MRI. In the meantime, my labs are back and I tested positive for JCV ANTIBODIES. My level is 3.45. Can you explain this information to me? I am in a panic and very nervous as to what this means.. Thank you.

Answer:
You have asked several different questions which I will try to address:

1. Regarding the optic nerve disease you have, the most common cause of optic nerve damage worldwide is glaucoma. However, if your ophthalmologist feels you do not have glaucoma then the MS would be the most likely explanation for your optic nerve damage.  MS effects the central nervous system which includes the brain, spinal cord and the optic nerves.
2. The positive JC antibody test means you have been exposed to the JC virus. You do not have an infection, however.  50-60% of the world has been exposed to the JC virus and it does not cause any health problems unless you have been exposed to certain risk factors.  In rare cases the JC virus can cause a brain infection (called PML). The most common risk factor for patients with MS for getting PML is if they go on a medication called Tysabri (natalizumab) AND they are JC antibody positive. This means your neurologist will probably recommend that you do not take the medication Tysabri.
3. Once you are diagnosed with MS it is important to start treatment as soon as possible. So you should follow up with your neurologist as soon as possible to discuss treatment options for your MS.  Fortunately there are a large number of medications approved by the FDA for treating MS so your doctor can recommend he/she thinks  is best for you.

Benjamin Osborne, MD
Director, Neuromyelitis Optica (NMO),Neuro-Ophthalmology Clinics and MS/Neuro-immunology Fellowship Director
Associate Director of the NIH/Georgetown Neurology Residency Program
Medstar Georgetown University Hospital