Highlights
- •In this prospective monocentric study, among 108 adult patients, 71 (65.7%) had multiple sclerosis (MS), 19 (17.6%) had idiopathic ON, 13 (12.0%) and 5 (4.6%) had myelin oligodendrocyte glycoprotein and aquaporin-4 antibodies, respectively.
- •At baseline, the distribution of bilateral ON, CSF-restricted oligoclonal bands, optic perineuritis, optic nerve length lesions and positive dissemination in space and dissemination in time criteria on MRI were different between the four groups.
- •No significant difference in visual acuity nor inner retinal layer thickness was found between the different ON aetiologies.
Abstract
Background
Previous cross-sectional studies have reported distinct clinical and radiological
features among the different acute optic neuritis (ON) aetiologies. Nevertheless,
these reports often included the same number of patients in each group, not taking
into account the disparity in frequencies of ON aetiologies in a real-life setting
and thus, it remains unclear what are the truly useful features for distinguishing
the different ON causes. To determine whether clinical evaluation, ophthalmological
assessment including the optical coherence tomography (OCT), CSF analysis, and MRI
imaging may help to discriminate the different causes of acute ON in a real-life cohort.
Methods
In this prospective monocentric study, adult patients with recent acute ON (<1 month)
underwent evaluation at baseline and 1 and 12 months, including, high- and low-contrast
visual acuity, visual field assessment and OCT measurements, baseline CSF analysis
and MRI.
Results
Among 108 patients, 71 (65.7%) had multiple sclerosis (MS), 19 (17.6%) had idiopathic
ON, 13 (12.0%) and 5 (4.6%) had myelin oligodendrocyte glycoprotein and aquaporin-4
antibodies, at last follow up respectively.At baseline, the distribution of bilateral
ON, CSF-restricted oligoclonal bands, optic perineuritis, optic nerve length lesions
and positive dissemination in space and dissemination in time criteria on MRI were
significantly different between the four groups (p <0.001). No significant difference
in visual acuity nor inner retinal layer thickness was found between the different
ON aetiologies.
Conclusions
In this large prospective study, bilateral visual involvement, CSF and MRI results
are the most useful clues in distinguishing the different aetiologies of acute ON,
whereas ophthalmological assessments including OCT measurements revealed no significant
difference between the aetiologies.
Keywords
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Article info
Publication history
Published online: May 15, 2023
Accepted:
May 14,
2023
Received in revised form:
May 3,
2023
Received:
March 16,
2023
Identification
Copyright
© 2023 Elsevier B.V. All rights reserved.
