Abstract
Purpose: :
To determine the clinical characteristics of Korean children with optic neuritis and the development of multiple sclerosis
Methods: :
A retrospective analysis was performed on 19 patients with onset of the disease before the age of 16 years from 1996 to 2005. Information on the sex, age of onset, laterality, initial visual acuity, final visual acuity, recent infections, and presence of systemic neurologic diseases, such as multiple sclerosis, and magnetic resonance images was obtained.
Results: :
There was female predilection in the study group (74%) with a mean age of 8.5 years at presentation. Bilateral involvement was observed in 53% of patients. A preceding febrile illness within 2 weeks of visual symptoms was reported in 45% of patients. Of the 29 involved eyes of 19 patients, disc swelling was present in 69%, and central/cecocentral scotoma in 45% of the involved eyes. With a mean follow–up of 17.5 months, 76% of the patients had final vision of >=20/40, 42 % of the patients had recurrences of optic neuritis. Twelve (71%) of 17 eyes with intravenous steroid treatment and 3 (43%) of 7 eyes without intravenous steroids showed final visual acuity >=20/40. The final visual acuity of eyes with intravenous steroids treatment was better than of eyes without treatment. (Mann–Whitney U test, p=0.02). Six patients (31.6%) developed multiple sclerosis. Two of the 3 patients with multifocal signal abnormalities around the periventricular white matter developed multiple sclerosis during the follow ups.
Conclusions: :
Korean children with optic neuritis showed bilateral involvement with papillitis. The visual prognosis was relatively good and especially better in the patients receiving intravenous steroid treatment than in those without any treatment. . The percentage of optic neuritis cases that developed multiple sclerosis in children was similar to that for children in Europe and North America. These findings can be taken as the characteristics of optic neuritis of children in Korea.
Keywords: clinical (human) or epidemiologic studies: natural history • neuro-ophthalmology: optic nerve