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A long-term prospective study of optic neuritis: evaluation of risk factors.

Abstract
Eighty-six patients with monosymptomatic optic neuritis of unknown cause were followed prospectively for a median period of 12.9 years. At onset, cerebrospinal fluid (CSF) pleocytosis was present in 46 patients (53%) but oligoclonal immunoglobulin in only 40 (47%) of the patients. The human leukocyte antigen (HLA)-DR2 was present in 45 (52%). Clinically definite multiple sclerosis (MS) was established in 33 patients. Actuarial analysis showed that the cumulative probability of developing MS within 15 years was 45%. Three risk factors were identified: low age and abnormal CSF at onset, and early recurrence of optic neuritis. Female gender, onset in the winter season, and the presence of HLA-DR2 antigen increased the risk for MS, but not significantly. Magnetic resonance imaging detected bilateral discrete white matter lesions, similar to those in MS, in 11 of 25 patients, 7 to 18 years after the isolated attack of optic neuritis. Nine were among the 13 with abnormal CSF and only 2 belonged to the group of 12 with normal CSF (p = 0.01). Normal CSF at the onset of optic neuritis conferred better prognosis but did not preclude the development of MS.
AuthorsM Sandberg-Wollheim, H Bynke, S Cronqvist, S Holtås, P Platz, L P Ryder
JournalAnnals of neurology (Ann Neurol) Vol. 27 Issue 4 Pg. 386-93 (Apr 1990) ISSN: 0364-5134 [Print] United States
PMID2353793 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • HLA Antigens
Topics
  • Adolescent
  • Adult
  • Female
  • HLA Antigens (immunology)
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis (cerebrospinal fluid, complications, diagnosis)
  • Optic Neuritis (cerebrospinal fluid, epidemiology, etiology)
  • Prognosis
  • Prospective Studies
  • Risk Factors
  • Sex Factors

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