Optic neuritis [ON] is generally identified as the most frequent potential risk factor associated with future development of multiple sclerosis [ms]. Whereas coherency in case of the adult disease is proved, findings concerning ms after childhood ON could not be demonstrated so far. The aim of this study consists of the identification of risk factors predicting later ms.
After a mean follow-up period of 18 years, 42 patients with ON in infancy participated on a standardized study including ophthalmologic, neurologic, electrophysiological and radiological examination.
6 out of 42 [14,3%] patients show radiological definite signs of ms, 10 out of 42 [23,8%] suspect and 26 out of 42 [61,9%] feature no evidence of ms. Subgroup analysis based on radiological data shows that male gender, early onset of ON, additional neurologic symptoms, positive lesions in mri and neurologic dysfunction in coordination in clinical follow-up significantly raise the risk of future ms. In contrary, female gender, severe lost of visual acuity combined with funduscopic findings [prominence>1dpt, hyperaemia] cause risk reduction of later ms.
In conclusion, ON in childhood is rare in comparison to ON in adulthood. Therapy with cortisone has a positive effect on progress of ON and minimizes the risk of later ms. Therefore treatment with cortisone is strongly indicated and recommended by proven diagnosis of ON.
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Elpers, C., Stupp, N., Grenzebach, U. et al. 38 Isolated Optic Neuritis in Infancy as a Predictor of Ms?. Pediatr Res 68, 22 (2010). https://doi.org/10.1203/00006450-201011001-00038