Optic Neuritis: Clinical Analysis of 27 Cases

Abstract

We retrospectively reviewed 27 cases diagnosed as idiopathic optic neuritis between 1992 and 2001 at Kaohsiung Veterans General Hospital to assess the clinical features, visual prognosis, neuroimaging, laboratory studies, and development of multiple sclerosis in Chinese patients with optic neuritis. Patient age ranged from 13 to 54 years (mean, 35.8 +/- 11.3 years). Five cases presented as bilateral optic neuritis and 22 as unilateral. Visual function improved gradually from 2 weeks after treatment. Twelve (44.4%) cases showed disc swelling and ocular pain was also noted in 44.4% of patients. All cases that underwent visual field and visual evoked potential tests showed abnormality in lesion eyes. Of the 23 cases that underwent neuroimaging studies, including computerized tomography (17 patients) and magnetic resonance imaging (6 patients), 10 revealed optic nerve thickening. Four cases (14.8%) developed multiple sclerosis during follow-up (mean, 4.3 years). The incidence of disc swelling was higher than that reported by the Optic Neuritis Treatment Trial, but the incidence of initial ocular pain, the presence of periventricular plaques, and the development of multiple sclerosis were lower in our study. The unilateral group had significantly better visual outcome than the bilateral group.

The Clinical Profile of Idiopathic Optic Neuritis at the Ophthalmology OPD of Tertiary Centre of Army Hospital, Nepal

“…72 5 and Taiwanese study 13 though our patients were younger than those reported from oriental countries. [3][4][5] Females are reported to be involved more frequently in the ONTT 2 and other studies [8][9][10][11][12][13][14][15][16] as against our study, where we found a slight male preponderance, which is in concurrence with the other reports from the eastern region of the world. [3][4][5][6][7]17 In our study 46.6% patients had painful ocular movement which is almost similar to Chinese study done by Zhang et al 4 (42.9%) and 40% in the study done in Far western and Mid western region of Nepal by Thapa et al 18 In other study from Nepal, Godar et al found higher (58%) and from India, Saxena et al also found had higher (66%) cases of painful ocular movement.…”

The Clinical Profile of Idiopathic Optic Neuritis at the Ophthalmology OPD of Tertiary Centre of Army Hospital, Nepal

“…72 5 and Taiwanese study 13 though our patients were younger than those reported from oriental countries. [3][4][5] Females are reported to be involved more frequently in the ONTT 2 and other studies [8][9][10][11][12][13][14][15][16] as against our study, where we found a slight male preponderance, which is in concurrence with the other reports from the eastern region of the world. [3][4][5][6][7]17 In our study 46.6% patients had painful ocular movement which is almost similar to Chinese study done by Zhang et al 4 (42.9%) and 40% in the study done in Far western and Mid western region of Nepal by Thapa et al 18 In other study from Nepal, Godar et al found higher (58%) and from India, Saxena et al also found had higher (66%) cases of painful ocular movement.…”

Association of Optic Neuritis with Neuromyelitis Optica Spectrum Disorder and Multiple Sclerosis in Korea

“…During the follow-up in this study, only 4% of ON patients developed definite MS on clinical grounds, consistent with other Asian results showing a relatively low percentage of MS in ON patients [23456]. The proportion of patients with NMO-IgG antibody was 14%.…”

“…Clinical characteristics of patients in this study were similar to those of previous studies in other Asian countries, including a lower percentage of the female gender, lower percentage of patients with pain, higher percentage of patients with severe initial visual loss, and lower percentage of patients with PVL and MS at presentation compared to data in the ONTT [23456719].…”

Neurological outcome and predictive factors of idiopathic optic neuritis in China

“…The 5-year and 10-year estimated combined cumulative conversion risk for progressing into MS or NMO after the initial ON event was 14.1% and 26.0% (95% CI, 14.4%-35.2%), respectively. This result was similar to the 14.8% MS conversion rate reported for Chinese population in Taiwan [12]. Compared with the rates reported in Western countries (which ranged from 25% to 30% at five years and 34% to 42% at 10 years [1][2][3][4][5]), both the averaged and the estimated cumulative conversion risk in our ION patients were much lower.…”

The Clinical Profile of Idiopathic Optic Neuritis at the Ophthalmology OPD of Tertiary Centre of Army Hospital, Nepal

“…72 5 and Taiwanese study 13 though our patients were younger than those reported from oriental countries. [3][4][5] Females are reported to be involved more frequently in the ONTT 2 and other studies [8][9][10][11][12][13][14][15][16] as against our study, where we found a slight male preponderance, which is in concurrence with the other reports from the eastern region of the world. [3][4][5][6][7]17 In our study 46.6% patients had painful ocular movement which is almost similar to Chinese study done by Zhang et al 4 (42.9%) and 40% in the study done in Far western and Mid western region of Nepal by Thapa et al 18 In other study from Nepal, Godar et al found higher (58%) and from India, Saxena et al also found had higher (66%) cases of painful ocular movement.…”

Association of Optic Neuritis with Neuromyelitis Optica Spectrum Disorder and Multiple Sclerosis in Korea

“…During the follow-up in this study, only 4% of ON patients developed definite MS on clinical grounds, consistent with other Asian results showing a relatively low percentage of MS in ON patients [23456]. The proportion of patients with NMO-IgG antibody was 14%.…”

“…Clinical characteristics of patients in this study were similar to those of previous studies in other Asian countries, including a lower percentage of the female gender, lower percentage of patients with pain, higher percentage of patients with severe initial visual loss, and lower percentage of patients with PVL and MS at presentation compared to data in the ONTT [23456719].…”

Neurological outcome and predictive factors of idiopathic optic neuritis in China

“…The 5-year and 10-year estimated combined cumulative conversion risk for progressing into MS or NMO after the initial ON event was 14.1% and 26.0% (95% CI, 14.4%-35.2%), respectively. This result was similar to the 14.8% MS conversion rate reported for Chinese population in Taiwan [12]. Compared with the rates reported in Western countries (which ranged from 25% to 30% at five years and 34% to 42% at 10 years [1][2][3][4][5]), both the averaged and the estimated cumulative conversion risk in our ION patients were much lower.…”

The Clinical Profile of Idiopathic Optic Neuritis at the Ophthalmology OPD of Tertiary Centre of Army Hospital, Nepal

“…72 5 and Taiwanese study 13 though our patients were younger than those reported from oriental countries. [3][4][5] Females are reported to be involved more frequently in the ONTT 2 and other studies [8][9][10][11][12][13][14][15][16] as against our study, where we found a slight male preponderance, which is in concurrence with the other reports from the eastern region of the world. [3][4][5][6][7]17 In our study 46.6% patients had painful ocular movement which is almost similar to Chinese study done by Zhang et al 4 (42.9%) and 40% in the study done in Far western and Mid western region of Nepal by Thapa et al 18 In other study from Nepal, Godar et al found higher (58%) and from India, Saxena et al also found had higher (66%) cases of painful ocular movement.…”

Association of Optic Neuritis with Neuromyelitis Optica Spectrum Disorder and Multiple Sclerosis in Korea

“…During the follow-up in this study, only 4% of ON patients developed definite MS on clinical grounds, consistent with other Asian results showing a relatively low percentage of MS in ON patients [23456]. The proportion of patients with NMO-IgG antibody was 14%.…”

“…Clinical characteristics of patients in this study were similar to those of previous studies in other Asian countries, including a lower percentage of the female gender, lower percentage of patients with pain, higher percentage of patients with severe initial visual loss, and lower percentage of patients with PVL and MS at presentation compared to data in the ONTT [23456719].…”

Neurological outcome and predictive factors of idiopathic optic neuritis in China

“…The 5-year and 10-year estimated combined cumulative conversion risk for progressing into MS or NMO after the initial ON event was 14.1% and 26.0% (95% CI, 14.4%-35.2%), respectively. This result was similar to the 14.8% MS conversion rate reported for Chinese population in Taiwan [12]. Compared with the rates reported in Western countries (which ranged from 25% to 30% at five years and 34% to 42% at 10 years [1][2][3][4][5]), both the averaged and the estimated cumulative conversion risk in our ION patients were much lower.…”