Optic neuritis in pediatric population: A review in current tendencies of diagnosis and management

Abstract

Optic neuritis is an inflammation of the optic nerve and may be related to different systemic conditions. The clinical presentation of this pathology usually includes sudden loss of visual acuity (VA) which may be unilateral or bilateral, visual field restriction, pain with eye movements, dyschromatopsia, a relative afferent pupillary defect and optic disk swelling. Optic neuritis in children has specific clinical features and a better prognosis than in adulthood. Although usually appears an underlying viral disease, the main concern for practitioners is the relationship of optic neuritis with multiple sclerosis. In addition to the classical techniques as magnetic resonance imaging (MRI), current tendencies of diagnosis for eye practitioners include new imaging devices as optical coherence tomography (OCT), useful to show a thinning of the retinal fibers layer (RFL) after the inflammatory episode. Regarding the management of these patients, short-term intravenous steroid dosages seem to be the best option to treat acute attacks characterized by a very poor bilateral VA.

Optic Neuritis in Korean Children: Low Risk of Subsequent Multiple Sclerosis

“…[5][6][7] Bilateral optic neuritis and papillitis are more common in children, and childhood optic neuritis is frequently associated with systemic infections or vaccinations. [7][8][9][10] In addition, optic neuritis in children has a better visual prognosis and a lower risk of a subsequent diagnosis of multiple sclerosis than that in adults. 7 The clinical characteristics of optic neuritis and multiple sclerosis have been reported to vary by race.…”

Cat Scratch Neuroretinitis

“…Another common finding in CSD, fever, was not manifest in this case [19]. Patients with CSNR can sometimes report ocular discomfort and it is important that other neurological conditions, where pain is more common, such as neuritis and neuromyelitis optica (NMO) be excluded [23,24]. Unlike optic neuritis and NMO, pain occurs in only in 25% of NR cases and is usually mild in nature [1].…”

Acute onset blindness: a case of optic neuritis and review of childhood optic neuritis

“…Younger children (<10 years of age) are more likely to have bilateral ON 14. A history of preceding upper respiratory tract infection is reported in 30–70% of cases7 15–17 and there may also have preceding headache/supraorbital pain or painful eye movements 10 18…”

“…The two consistent risk factors for MS following an episode of ON include positive MRI brain lesions at presentation of ON7 15 and presence of CSF oligoclonal bands 18 28 29. It remains unclear if the age of onset of ON influences the future risk of MS 8 14…”