Update on pediatric optic neuritis

Lock, Jane; Newman, Nancy J.; Biousse, Valérie; Peragallo, Jason H.

doi:10.1097/icu.0000000000000607

Cited by 30 publications

(38 citation statements)

References 98 publications

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“…Paediatric MOG-ab-positive patients presenting with ON predominantly are adolescents between 13 and 18 years of age [13,25,28,47]. In patients with ON as clinically isolated syndrome, paediatric ON has different clinical features than ON in adults (most likely representing MS patients), regarding severity, bilateral vs. unilateral, and presence of disc oedema [48]. Studies exclusively analysing paediatric patients with MOG-ab-associated ON (MOG-ON) are limited.…”

Section: Optic Neuritis (On)mentioning

confidence: 99%

“…In 2012, a study reported that a proportion of MOG-ab-positive children with ON will experience further relapse(s), and suggested that these patients represent a separate subgroup distinct from MS or NMOSD [19]. Subsequently, several studies confirmed that paediatric MOG-ON patients show higher rates of recurrence compared to paediatric MOG-ab-negative [36,38] and MS patients with ON [48]. These relapses have been shown to be highly steroidresponsive, or even steroid-dependent.…”

Section: Relapsing On (Ron)mentioning

confidence: 99%

See 1 more Smart Citation

E.U. paediatric MOG consortium consensus: Part 1 – Classification of clinical phenotypes of paediatric myelin oligodendrocyte glycoprotein antibody-associated disorders

consortium¹,

Bruijstens

Wendel³

et al. 2020

European Journal of Paediatric Neurology

105

114

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Over the past few years, increasing interest in the role of autoantibodies against myelin oligodendrocyte glycoprotein (MOG-abs) as a new candidate biomarker in demyelinating central nervous system diseases has arisen. MOG-abs have now consistently been identified in a variety of demyelinating syndromes, with a predominance in paediatric patients. The clinical spectrum of these MOG-ab-associated disorders (MOGAD) is still expanding and differs between paediatric and adult patients. This first part of the Paediatric European Collaborative Consensus emphasises the diversity in clinical phenotypes associated with MOG-abs in paediatric patients and discusses these associated clinical phenotypes in detail. Typical MOGAD presentations consist of demyelinating syndromes, including acute disseminated encephalomyelitis (ADEM) in younger, and optic neuritis (ON) and/or transverse myelitis (TM) in older children. A proportion of patients experience a relapsing disease course, presenting as ADEM followed by one or multiple episode(s) of ON (ADEM-ON), multiphasic disseminated encephalomyelitis (MDEM), relapsing ON (RON) or relapsing neuromyelitis optica spectrum disorders (NMOSD)-like syndromes. More recently, the disease spectrum has been expanded with clinical and radiological phenotypes including encephalitis-like, leukodystrophy-like, and other non-classifiable presentations. This review concludes with recommendations following expert consensus on serologic testing for MOG-abs in paediatric patients, the presence of which has consequences for long-term monitoring, relapse risk, treatments, and for counselling of patient and families. Furthermore, we propose a clinical classification of paediatric MOGAD with clinical definitions and key features. These are operational and need to be tested, however essential for future paediatric MOGAD studies.

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Section: Optic Neuritis (On)mentioning

confidence: 99%

Section: Relapsing On (Ron)mentioning

confidence: 99%

E.U. paediatric MOG consortium consensus: Part 1 – Classification of clinical phenotypes of paediatric myelin oligodendrocyte glycoprotein antibody-associated disorders

consortium¹,

Bruijstens

Wendel³

et al. 2020

European Journal of Paediatric Neurology

105

114

View full text Add to dashboard Cite

show abstract

“…Optic neuritis is an in ammatory condition of the optic nerve, that causes visual impairment and is associated to demyelinating in ammatory diseases in most non-idiopathic cases (Lock et al 2019). Initial visual acuity of optic neuritis, varies from normal to no light perception, although it is usually poor in children.…”

Section: ; Choi Et Al 2015; Fernandez-cooke Et Al 2019)mentioning

confidence: 99%

“…To date, the pathogenic origin of these lesions remains unknown. SARS-CoV-2 enters the cells via the angiotensin-converting enzyme II (ACE-2) which is only present in the retina and aqueous humour (Lock et al 2019). This warned us about the possibility of anterior uveitis or posterior pole in involvement.…”

Section: ; Choi Et Al 2015; Fernandez-cooke Et Al 2019)mentioning

confidence: 99%

COVID-19 ocular findings in paediatric population

Alcalde

Fernández

Moreno

et al. 2020

Preprint

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Purpose To investigate and describe ocular findings in COVID-19 paediatric patients. Methods A total of 17 COVID-19 patients aged between 0 and 17 years old were recruited at the Paediatric Hospital of La Paz University Hospital (Madrid, Spain). A complete ophthalmological examination was performed in all patients. Results Of 17 patients, 50% had a known COVID-19 previous exposure. PCR from nasopharyngeal swabs was positive in 35.29%, whereas IgM and/or IgG serology tests were positive in 81%. Clinical manifestations were: 6 COVID-19associated Paediatric Inflammatory Multisystem Syndrome (PIMS), 7 pneumonias and 2 cutaneous purpura and/or chilblains. Ocular findings were ocular hyperaemia (5 patients), as bilateral acute conjunctivitis (3 patients) or unilateral episcleritis (2 patients). Mean best corrected visual acuity was 1/1 in all tested cases. Only one patient, presenting unilateral optic neuritis, had visual symptoms as unilateral inferior temporal quadrantanopsy. Retinal involvement was found in one patient, where ocular fundus exam showed unilateral retinal vasculitis. Conclusion SARS-CoV-2 infection could produce ocular pathology in children, frequently presented weeks after the acute phase of the disease. We should take into account COVID-19 when performing differential diagnosis of children presenting with conjunctivitis, episcleritis, retinal vasculitis and/or optic neuritis, meanwhile this world-wide pandemic lasts.

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“…Common neuro-inflammatory syndromes that cause demyelinating optic neuritis in children include multiple sclerosis (MS), acute disseminated encephalomyelitis (ADEM), neuromyelitis optica spectrum disorder (NMOSD), or Myelin-oligodendrocyte glycoprotein (MOG) associated optic neuritis. [ 4 5 7 8 9 ] Following the widespread availability of MOG antibody testing, studies have shown a high frequency of positivity for MOG antibodies in children presenting with optic neuritis. [ 5 7 ]…”

mentioning

confidence: 99%

Working up a child with demyelinating optic neuritis: Striking a balance!

Sachdeva

Kekunnaya

2021

Oman J Ophthalmol

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Pediatric optic neuritis (PON) is one of the commonest causes of acute vision loss in children. Although it might often be postinfectious or postvaccination, recent understanding and available evidence suggest that it can be the first manifestation of a neuro-inflammatory syndrome such as multiple sclerosis, neuromyelitis optica spectrum disorder, acute disseminated encephalomyelitis or myelin oligodendrocyte glycoprotein associated optic neuritis. Therefore, neuroimaging, serological testing, cerebrospinal fluid analysis, testing for various systemic autoimmune conditions become a part of the workup. However, this can be exhaustive and expensive, especially in countries with limited access to health insurance. Many recent studies suggest that neuroimaging and few clinical features can provide clues to the underlying etiology. However, serological tests can provide a confirmatory evidence. Therefore, in this mini-review, we propose a balanced approach to the evaluation of PON, based on the available literature emanating in the last decade.

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Update on pediatric optic neuritis

Cited by 30 publications

References 98 publications

E.U. paediatric MOG consortium consensus: Part 1 – Classification of clinical phenotypes of paediatric myelin oligodendrocyte glycoprotein antibody-associated disorders

E.U. paediatric MOG consortium consensus: Part 1 – Classification of clinical phenotypes of paediatric myelin oligodendrocyte glycoprotein antibody-associated disorders

COVID-19 ocular findings in paediatric population

Working up a child with demyelinating optic neuritis: Striking a balance!

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