The clinical features, MRI findings, and outcome of optic neuritis in children

Wilejto, Marta; Shroff, Manohar; Buncic, J. Raymond; Kennedy, J. S.; Goia, C.; Banwell, Brenda

doi:10.1212/01.wnl.0000224757.69746.fb

Cited by 188 publications

(169 citation statements)

References 14 publications

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“…12 We previously assessed 36 children with ON and found that full visual recovery occurred in 39 of 47 affected eyes, despite 69% having a visual deficit worse than or equal to 20/200 at onset. 13 Clinical recovery occurred quickly in our patients, with normalization of the neurologic examination by 3 months in nearly all children; a small number of children demonstrated further improvement at 12 months, and 7 children improved further beyond 12 months. ADS severity at onset was associated with the risk of residual deficits; however, most children with severe deficits recovered.…”

Section: Clinical Severitymentioning

confidence: 54%

“…Children with ADEM had the longest hospital stays, whereas children with ON had the shortest hospital stays ( Severe deficits in $1 feature of vision, motor, bladder and bowel function, or cognition were detected at ADS onset in 133 (47.0%) of 283 children, whereas 51 (18.0%) children had $1 moderate deficit, and 79 (27.9%) children had at least 1 mild deficit (Supplemental Fig 3A). Twenty (7.1%) children had a normal examination at study enrollment (days from onset, median [range]: 9 [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]); all had at least 1 deficit at onset verified according to records review of their presenting examination.…”

Section: Clinical Severitymentioning

confidence: 99%

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Recovery From Central Nervous System Acute Demyelination in Children

et al. 2015

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Section: Clinical Severitymentioning

confidence: 54%

Section: Clinical Severitymentioning

confidence: 99%

Recovery From Central Nervous System Acute Demyelination in Children

et al. 2015

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“…We could document the history of viral prodrome in 6 (21.4%) patients. Wilejto et al 12 documented viral prodrome in 28% of the optic neuritis patients. Kennedy et al 10 suggested that there is no significantly better visual prognosis in children having retrobulbar neuritis as opposed to those having papillitis.…”

Section: -19mentioning

confidence: 99%

“…The published data has quoted 42-100% of the pediatric patients to have a bilateral presentation. [10][11][12][13][14][15][16][17][18][19][20] A second noteworthy ocular finding in pediatric optic neuritis is the large number of patients who had papillitis. Kennedy et al 10 noted that more than 70% of the children had some degree of papillitis, normal discs being noted in only three cases (10%).…”

Section: -19mentioning

confidence: 99%

Clinical Spectrum of Pediatric Optic Neuritis in Indian Children

Singh¹,

Phuljhele²,

Sharma³

et al. 2017

Ophthalmol Open J

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Purpose: To study the clinical spectrum of pediatric optic neuritis in Indian children at a tertiary care centre. Methods: A retrospective study of patients diagnosed with optic neuritis below 20 years of age at a tertiary care centre in India over a 3 year period were reviewed. The ophthalmological examination findings, Goldmann perimetry, electrophysiological tests and magnetic resonance imaging (MRI) were reviewed. Results: The study reviewed 28 patients (44 eyes) and found a mean age of 12.6±4.9 years (2-20 years) having a follow-up record for a mean period of 6.3±4.9 months (0.3-38 months). 32.1% were females (F: M-0.47). Six patients (20.7%) had a viral prodrome and 12 (42.9%) complained of painful ocular movements. The mean baseline visual acuity (VA) was 1.80±0.6 logMAR units (Range=0.2-3.0 logMAR units) and the last best visual acuity was 0.43±0.4 log MAR units (Range=0-1.79 logMAR units). Thirty six eyes (81.8%) had a visual acuity at or below 3/60 and 40 eyes (90.9%) of 6/60 or lower of the snellen chart at the time of presentation. The mean contrast sensitivity at presentation was 1.02±0.46 (range=0-1.65). 16 pts (57.1%) had a bilateral presentation and 20 patients (71.4%) had either unilateral or bilateral papillitis. All the patients were given pulse dexamethasone (3-5 mg/kg/d) for three consecutive days followed by oral prednisolone (1-1.5 mgKg/day) for 11 days. At 1 week, 21 out of 44 eyes (47.7%) had a visual acuity ≥6/18 of the snellen chart. Three patients showed demyelination suggestive of multiple sclerosis (MS) on MRI brain and were diagnosed as probable MS. A total of 9 eyes (20.5%) of 6 patients (20.7%) had a recurrence. Those below 10 years of age presented more commonly with papillitis compared to teenagers (p value=0.01). All the parameters were similar in males and females. Conclusion: Pediatric optic neuritis patients are associated with a good visual outcome and a faster recovery. There are no gender differences in either the presentation or the visual recovery. Papillitis was more often seen in the children below 10 years of age. None of the patients developed clinically definite multiple sclerosis.

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“…With the technical advancement of MRI, there have been a number of studies that have not only demonstrated the usefulness of MRI but also shown an improvement in the certainty of the diagnosis [2][3][4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Quantitative Evaluation of Signal Intensity of Magnetic Resonance Images in Optic Neuritis

Hanawa¹,

Mizota²

2007

TOOPHTJ

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Abstract:We have evaluated the signal intensity of magnetic resonance (MR) images of the optic nerve quantitatively in 25 patients with unilateral acute optic neuritis (ON). MR imaging was performed with a 1.5 Tesla unit before treatment within 2 weeks after the onset of ON. Four coronal fat-suppressed T2-weighted images were obtained at 5, 10, 15, and 20 mm behind the eye. The ratio of the signal intensity of the MR images from the optic nerve to that of the white matter of the frontal lobe was calculated and we compared the signal intensity ratio of the affected eyes to the fellow healthy eyes. For statistical analysis paired t-test was used. At all 4 sections, the mean signal intensity ratio of the affected eyes is statistically significant higher than fellow eyes. The 11 patients showed optic disc swelling in the affected eyes and in all these 11 eyes had a higher signal intensity at 5 mm behind the eye compared with the fellow eye. From our present results, we cannot refer to the sensitivity of our method, because we did not use our present methods to other diseases. But with this method we think inter-image and inter-observer variability must reduce. Further studies are required about the sensitivity and the relation between the pathological condition of optic nerve and the signal intensity ratio.

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The clinical features, MRI findings, and outcome of optic neuritis in children

Cited by 188 publications

References 14 publications

Recovery From Central Nervous System Acute Demyelination in Children

Recovery From Central Nervous System Acute Demyelination in Children

Clinical Spectrum of Pediatric Optic Neuritis in Indian Children

Quantitative Evaluation of Signal Intensity of Magnetic Resonance Images in Optic Neuritis

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