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Childhood optic neuritis clinical features and outcome
  1. Michael Absoud1,
  2. Carole Cummins1,
  3. Nivedita Desai2,
  4. Artemis Gika3,
  5. Niamh McSweeney2,
  6. Pinki Munot2,
  7. Cheryl Hemingway2,
  8. Ming Lim3,
  9. Ken K Nischal4,
  10. Evangeline Wassmer5
  1. 1Institute of Child Health, Birmingham Children's Hospital, Birmingham, UK
  2. 2Paediatric Neurology Department, Great Ormond Street Hospital, London, UK
  3. 3Paediatric Neurology Department, The Evelina Children's Hospital, London, UK
  4. 4Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital, London, UK
  5. 5Paediatric Neurology Department, Birmingham Children's Hospital, Birmingham, UK
  1. Correspondence to Dr Michael Absoud, Clinical Research Fellow, Third Floor, Institute of Child Health, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH; michaelabsoud{at}childdemyelination.org.uk

Abstract

Aim To describe clinical features and outcome of a series of children with first-episode optic neuritis investigated in three paediatric neurology centres.

Methods Databases were searched to identify children (<16 years) with optic neuritis and life table analysis was used.

Results 44 children (female/male ratio 1.8) median age 10.9 years were followed up for median 1 year. Optic neuritis was unilateral in 43%. Maximal visual deficit was severe (<6/60) in 77%, with full recovery in 70%. Cumulative probability of developing MS (11/44) or NMO (3/44) at 2 years was 0.45. Relapsing optic neuritis was a strong predictor for development of MS or NMO. A positive MRI (>1 brain T2 hyperintense lesion) was a strong predictor for development of MS.

Discussion Childhood optic neuritis is associated with severe visual deficit with good recovery. An initial abnormal MRI brain scan or relapsing optic neuritis should alert the clinician to MS or NMO diagnosis.

https://doi.org/10.1136/adc.2009.175422

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    Footnotes

    • Competing interests None.

    • Provenance and peer review Not commissioned; externally peer reviewed.