Paediatric optic neuritis: factors leading to unfavourable outcome and relapses. Issue 6 (13th September 2017)

• Record Type: Journal Article
• Authors: Averseng-Peaureaux, Delphine; Mizzi, Marie; Colineaux, Helene; Mahieu, Laurence; Pera, Maria Carmela; Brassat, David; Chaix, Yves; Berard, Emilie; Deiva, Kumaran; Cheuret, Emmanuel
• Is Part Of: British journal of ophthalmology. Volume 102:Issue 6(2018)
• Page Start: 808
• Page End: 813
• Publication Date: 2017-09-13
• Subjects: optic neuritis -- pediatric -- multiple sclerosis -- prognostic factors -- demyelination; Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjophthalmol-2016-309978
• Languages: English
• ISSNs: 0007-1161

Abstract

Abstract : Objectives: To identify prognostic factors associated with poor visual recovery and chronic relapsing diseases, for example, multiple sclerosis (MS), in children with optic neuritis (ON) at onset. Methods: This multicentre retrospective study included 102 children with a first ON episode between 1990 and 2012. The primary criterion was poor visual recovery determined by visual acuity, and the secondary was relapses following ON. Results: Median age was 11 years, 66% were girls and mean follow-up was 24 months. 58% of children were diagnosed with idiopathic isolated ON, 22% had MS, 5% had Devic's neuromyelitis optica and 6% chronic relapsing inflammatory ON. Complete visual acuity recovery rate was 57% (95% CI=[46%-69%]) at 6 months and 71% (95% CI=[60%-81%]) at 1 and 2 years but was lower in MS (p<0.01), with recovery rate of only 27% (95% CI=[12%-54%]) at 1 year. Age ≥10 years, optic disc pallor at funduscopy and MS were the principal factors associated with poor visual recovery. Age ≥10 years, abnormal brain MRI at onset and oligoclonal banding were significantly associated with MS (p<0.01). Conclusion: Age ≥10, optic disc pallor and MS were associated with poor recovery. Better identification of these patients may help to adapt treatment and lead to a prospective treatment study.