• Media type: E-Article
  • Title: Paediatric optic neuritis: factors leading to unfavourable outcome and relapses
  • Contributor: Averseng-Peaureaux, Delphine; Mizzi, Marie; Colineaux, Helene; Mahieu, Laurence; Pera, Maria Carmela; Brassat, David; Chaix, Yves; Berard, Emilie; Deiva, Kumaran; Cheuret, Emmanuel
  • imprint: BMJ, 2018
  • Published in: British Journal of Ophthalmology
  • Language: English
  • DOI: 10.1136/bjophthalmol-2016-309978
  • ISSN: 0007-1161; 1468-2079
  • Origination:
  • Footnote:
  • Description: <jats:sec><jats:title>Objectives</jats:title><jats:p>To identify prognostic factors associated with poor visual recovery and chronic relapsing diseases, for example, multiple sclerosis (MS), in children with optic neuritis (ON) at onset.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This multicentre retrospective study included 102 children with a first ON episode between 1990 and 2012. The primary criterion was poor visual recovery determined by visual acuity, and the secondary was relapses following ON.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Median age was 11 years, 66% were girls and mean follow-up was 24 months. 58% of children were diagnosed with idiopathic isolated ON, 22% had MS, 5% had Devic’s neuromyelitis optica and 6% chronic relapsing inflammatory ON. Complete visual acuity recovery rate was 57% (95% CI=[46%-69%]) at 6 months and 71% (95% CI=[60%-81%]) at 1 and 2 years but was lower in MS (p&lt;0.01), with recovery rate of only 27% (95% CI=[12%-54%]) at 1 year. Age ≥10 years, optic disc pallor at funduscopy and MS were the principal factors associated with poor visual recovery. Age ≥10 years, abnormal brain MRI at onset and oligoclonal banding were significantly associated with MS (p&lt;0.01).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Age ≥10, optic disc pallor and MS were associated with poor recovery. Better identification of these patients may help to adapt treatment and lead to a prospective treatment study.</jats:p></jats:sec>