Abstract
Purpose: :
To examine the natural history of optic neuritis in patients of Indian ethnicity referred to the neuroophthalmology clinic of a teaching hospital in the United Kingdom.
Methods: :
Patients of Indian ethnicity were identified from a database of patients diagnosed with optic neuritis seen in the neuroophthalmology clinic from October 1996 to October 2005. The case notes were analysed retrospectively. The patient demographics, presenting features, clinical findings, investigations, aetiology, treatment and outcome were studied.
Results: :
Eleven eyes of 6 patients were identified (2 males and 4 females). The average age of presentation was 34.5 years (range– 27– 45). All patients presented with reduction in vision in the affected eye(s) but with no significant ocular pain. All patients presented with retrobulbar optic neuritis. Four patients had ocular motility abnormalities, including 3 with associated nystagmus. Three of the 6 patients had persistent reduction in Snellen visual acuity in the affected eye(s) but all patients had some degree of colour vision or visual field deficit. All 6 patients were diagnosed with demyelinating disease with supporting MRI findings.
Conclusions: :
There appear to be important differences in the natural history of optic neuritis between ethnic Indians living in the United Kingdom and the general population. Optic neuritis in this group of patients shows a more aggressive disease process with a higher prevalence of bilateral cases and poorer visual outcomes. In addition, the strong association with demyelination is an important new finding.
Keywords: neuro-ophthalmology: optic nerve