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Acute idiopathic optic neuritis: not always benign
Author(s) -
Deschamps R.,
Gueguen A.,
Lecler A.,
Lecouturier K.,
Lamirel C.,
Bensa C.,
Marignier R.,
Vignal C.,
Gout O.
Publication year - 2018
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13753
Subject(s) - medicine , optic neuritis , neuromyelitis optica , myelin oligodendrocyte glycoprotein , multiple sclerosis , visual acuity , magnetic resonance imaging , cohort , retrospective cohort study , ophthalmology , radiology , experimental autoimmune encephalomyelitis , psychiatry
Background and purpose Few recent data are available concerning idiopathic optic neuritis ( ON ). We aimed to describe a large cohort of patients with idiopathic ON . We compared this cohort with patients with ON related to myelin oligodendrocyte glycoprotein ( MOG ) or ON related to aquaporin‐4 ( AQP 4) antibodies. Methods This was a monocentric retrospective observational study. Inclusion criteria for idiopathic ON were as follows: age ≥ 16 years, follow‐up of at least 2 years, negative for antibodies against MOG and AQP 4 immunoglobulin G, and no magnetic resonance imaging ( MRI ) lesions suggestive of demyelination (two brain MRI scans, one at baseline and one during follow‐up, and one spinal cord MRI scan). Results Among 23 patients with idiopathic ON (female, 82.6%; median age, 36 years; median follow‐up time, 41.4 months), 56.5% had recurrent ON (median time to a second ON episode, 6 months). The final visual acuity in this group (median, 0; mean, 0.43; range, 0–3) was similar to that in the AQP 4 group ( n = 18; P ‐value after Bonferroni correction = 0.936) but worse than that in the MOG group ( n = 25; P ‐value after Bonferroni correction = 0.019). At the last evaluation, visual acuity levels were ≤0.5 and <0.2, respectively, in 36.8% and 21% of the idiopathic ON group, 58.3% and 26.7% of the AQP 4 group, and 0% and 0% of the MOG group. Conclusion The recovery of visual acuity among patients with idiopathic ON was poor, similar to that observed in the AQP 4 group.