A long‐term prospective study of optic neuritis: Evaluation of risk factors

Abstract

Eighty-six patients with monosymptomatic optic neuritis of unknown cause were followed prospectively for a median period of 12.9 years. At onset, cerebrospinal fluid (CSF) pleocytosis was present in 46 patients (53%) but oligoclonal immunoglobulin in only 40 (47%) of the patients. The human leukocyte antigen (HLA)-DR2 was present in 45 (52%). Clinically definite multiple sclerosis (MS) was established in 33 patients. Actuarial analysis showed that the cumulative probability of developing MS within 15 years was 45%. Three risk factors were identified: low age and abnormal CSF at onset, and early recurrence of optic neuritis. Female gender, onset in the winter season, and the presence of HLA-DR2 antigen increased the risk for MS, but not significantly. Magnetic resonance imaging detected bilateral discrete white matter lesions, similar to those in MS, in 11 of 25 patients, 7 to 18 years after the isolated attack of optic neuritis. Nine were among the 13 with abnormal CSF and only 2 belonged to the group of 12 with normal CSF (p = 0.01). Normal CSF at the onset of optic neuritis conferred better prognosis but did not preclude the development of MS.

A Longitudinal Study of Abnormalities on MRI and Disability from Multiple Sclerosis

“…1,2 Ninety percent of patients with multiple sclerosis first present in this way. The presence of cerebral white-matter lesions as determined by T 2 -weighted magnetic resonance imaging I (MRI) at presentation (found in 50 to 70 percent of patients with isolated syndromes) [3][4][5] is associated with an increased risk of multiple sclerosis.…”

Nerve Fibre Layer Analysis with GDx with a Variable Corneal Compensator in Patients with Multiple Sclerosis

“…One of the characteristic signs of multiple sclerosis (MS), both clinically and sub-clinically, is demyelinizating optic neuropathy [1,2,3,4,5]. The diagnosis of MS is evident in cases of acute retrobulbar optic neuritis (ON); however, ON might also occur silently at any time during the course of MS.…”

Beta interferons in clinically isolated syndromes: a meta-analysis

“…Thus, although some predictors of prognosis in MS have been well identified 1 , there are only few papers regarding the risk factors of CIS conversion to CDMS 18 . Brain MRI and oligoclonal IgG band (OCGB) detection are the most frequent paraclinical tests used in MS diagnosis 8,19 . According to Barkhoff et al, CIS patients with high risk of conversion to CDMS are defined…”