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Clinical science
Paediatric optic neuritis: factors leading to unfavourable outcome and relapses
  1. Delphine Averseng-Peaureaux1,
  2. Marie Mizzi2,
  3. Helene Colineaux3,
  4. Laurence Mahieu4,
  5. Maria Carmela Pera5,6,
  6. David Brassat7,
  7. Yves Chaix8,
  8. Emilie Berard3,
  9. Kumaran Deiva5,6,
  10. Emmanuel Cheuret2
  11. on behalf of Kidbiosep study group
  1. 1 Department of Neurology, Hôpital Pierre Paul Riquet, CHU Purpan, Toulouse, France
  2. 2 Department of Pediatric Neurology, Hôpitaldes Enfants, CHU Purpan, Toulouse, France
  3. 3 Department of Public Health and Epidemiology, Hôpital Purpan and Toulouse III University, Toulouse, France
  4. 4 Department of Ophthalmology, Retinal Center, Hôpital Pierre Paul Riquet, CHU Purpan, Toulouse, France
  5. 5 Department of Pediatric Neurology, Assistance Publique-Hôpitaux de Paris, Hopitaux Universitaires Paris-Sud, Hôpital Bicêtre, National Referral Center for Neuro-Inflammatory Diseases in Children, Paris, France
  6. 6 Université Paris-Sud, UMR 1184, CEA, IDMIT, Center for Immunology of Viral Infections and Autoimmune Diseases, Paris, France
  7. 7 Centre Hospitalier Universitaire Toulouse, Pole des Neurosciences, CPTP INSERM UMR 1043 et Université de Toulouse, Toulouse, France
  8. 8 Inserm, Imagerie Cérébrale et Handicaps Neurologiques UMR 825, Université de Toulouse III - Paul Sabatier, Toulouse, France
  1. Correspondence to Dr Emmanuel Cheuret, Hôpital des Enfants, CHU Purpan, Pediatric Neurology Department, Place du Dr Baylac, 31059 Toulouse cedex, France; echeuret{at}gmail.com

Abstract

Objectives To identify prognostic factors associated with poor visual recovery and chronic relapsing diseases, for example, multiple sclerosis (MS), in children with optic neuritis (ON) at onset.

Methods This multicentre retrospective study included 102 children with a first ON episode between 1990 and 2012. The primary criterion was poor visual recovery determined by visual acuity, and the secondary was relapses following ON.

Results Median age was 11 years, 66% were girls and mean follow-up was 24 months. 58% of children were diagnosed with idiopathic isolated ON, 22% had MS, 5% had Devic’s neuromyelitis optica and 6% chronic relapsing inflammatory ON. Complete visual acuity recovery rate was 57% (95% CI=[46%-69%]) at 6 months and 71% (95% CI=[60%-81%]) at 1 and 2 years but was lower in MS (p<0.01), with recovery rate of only 27% (95% CI=[12%-54%]) at 1 year. Age ≥10 years, optic disc pallor at funduscopy and MS were the principal factors associated with poor visual recovery. Age ≥10 years, abnormal brain MRI at onset and oligoclonal banding were significantly associated with MS (p<0.01).

Conclusion Age ≥10, optic disc pallor and MS were associated with poor recovery. Better identification of these patients may help to adapt treatment and lead to a prospective treatment study.

  • optic neuritis
  • pediatric
  • multiple sclerosis
  • prognostic factors
  • demyelination

http://dx.doi.org/10.1136/bjophthalmol-2016-309978

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    Footnotes

    • DA-P and MM contributed equally.

    • Competing interests This work is a part of medical thesis of the second author, MM.

    • Ethics approval The hospital ethics committee approved the study design.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement EC and KD take full responsibility for the data, analysis, interpretation and the conduct of the research. They have full access to all of the data and the right to publish any and all data. Unpublished data from the study belong to them as they generated these results.

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