Long-term follow-up of isolated optic neuritis: The risk of developing multiple sclerosis, its outcome, and the prognostic role of paraclinical tests

A. Ghezzi, V. Martinelli, V. Torri, M. Zaffaroni, M. Rodegher, G. Comi, A. Zibetti, N. Canal

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Abstract

We evaluated the risk of developing clinically definite multiple sclerosis (CDMS) after an acute attack of isolated optic neuritis (ON) in 112 patients, in relation to demographic and paraclinical findings. Patients were examined by brain MRI, CSF analysis, and multiple evoked potentials (EPs); 10 were lost to follow-up, and the other 102 were enrolled in a prospective study (follow-up duration 6.3 ± 2.2 years). Of these, 37 (36.3%) developed CDMS after a mean interval of 2.3 ± 1.6 years. The risk of developing CDMS was 13% after 2 years, 30% after 4, 37% after 6, and 42% after 8 and 10 years. Gender, age, and season of ON onset did not affect the risk. MS occurred in 37 of 71 patients (52.1%) with one MRI lesion or more; no patient with a normal MRI developed the disease. MS developed more frequently in patients with intrathecal IgG synthesis than in those without (43% vs. 28%), but the difference was not statistically significant. Multiple EPs showed a slight predictive value only including somatosensory EPs of the lower limb. Multiple sclerosis was mild in most cases (EDSS 2.2 ± 1.9). The EDSS was less than 4 in 32 cases (86%), between 4 and 6 in 2 (5%), higher than 6.5 in 3 (8%).

Original languageEnglish
Pages (from-to)770-775
Number of pages6
JournalJournal of Neurology
Volume246
Issue number9
DOIs
Publication statusPublished - 1999

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Optic Neuritis
Multiple Sclerosis
Evoked Potentials
Somatosensory Evoked Potentials
Lost to Follow-Up
Lower Extremity
Immunoglobulin G
Demography
Prospective Studies
Brain

Keywords

  • CSF examination
  • Evoked potentials
  • Magnetic resonance imaging
  • Multiple sclerosis
  • Oligoclonal bands
  • Optic neuritis

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

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title = "Long-term follow-up of isolated optic neuritis: The risk of developing multiple sclerosis, its outcome, and the prognostic role of paraclinical tests",
abstract = "We evaluated the risk of developing clinically definite multiple sclerosis (CDMS) after an acute attack of isolated optic neuritis (ON) in 112 patients, in relation to demographic and paraclinical findings. Patients were examined by brain MRI, CSF analysis, and multiple evoked potentials (EPs); 10 were lost to follow-up, and the other 102 were enrolled in a prospective study (follow-up duration 6.3 ± 2.2 years). Of these, 37 (36.3{\%}) developed CDMS after a mean interval of 2.3 ± 1.6 years. The risk of developing CDMS was 13{\%} after 2 years, 30{\%} after 4, 37{\%} after 6, and 42{\%} after 8 and 10 years. Gender, age, and season of ON onset did not affect the risk. MS occurred in 37 of 71 patients (52.1{\%}) with one MRI lesion or more; no patient with a normal MRI developed the disease. MS developed more frequently in patients with intrathecal IgG synthesis than in those without (43{\%} vs. 28{\%}), but the difference was not statistically significant. Multiple EPs showed a slight predictive value only including somatosensory EPs of the lower limb. Multiple sclerosis was mild in most cases (EDSS 2.2 ± 1.9). The EDSS was less than 4 in 32 cases (86{\%}), between 4 and 6 in 2 (5{\%}), higher than 6.5 in 3 (8{\%}).",
keywords = "CSF examination, Evoked potentials, Magnetic resonance imaging, Multiple sclerosis, Oligoclonal bands, Optic neuritis",
author = "A. Ghezzi and V. Martinelli and V. Torri and M. Zaffaroni and M. Rodegher and G. Comi and A. Zibetti and N. Canal",
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T1 - Long-term follow-up of isolated optic neuritis

T2 - The risk of developing multiple sclerosis, its outcome, and the prognostic role of paraclinical tests

AU - Ghezzi, A.

AU - Martinelli, V.

AU - Torri, V.

AU - Zaffaroni, M.

AU - Rodegher, M.

AU - Comi, G.

AU - Zibetti, A.

AU - Canal, N.

PY - 1999

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N2 - We evaluated the risk of developing clinically definite multiple sclerosis (CDMS) after an acute attack of isolated optic neuritis (ON) in 112 patients, in relation to demographic and paraclinical findings. Patients were examined by brain MRI, CSF analysis, and multiple evoked potentials (EPs); 10 were lost to follow-up, and the other 102 were enrolled in a prospective study (follow-up duration 6.3 ± 2.2 years). Of these, 37 (36.3%) developed CDMS after a mean interval of 2.3 ± 1.6 years. The risk of developing CDMS was 13% after 2 years, 30% after 4, 37% after 6, and 42% after 8 and 10 years. Gender, age, and season of ON onset did not affect the risk. MS occurred in 37 of 71 patients (52.1%) with one MRI lesion or more; no patient with a normal MRI developed the disease. MS developed more frequently in patients with intrathecal IgG synthesis than in those without (43% vs. 28%), but the difference was not statistically significant. Multiple EPs showed a slight predictive value only including somatosensory EPs of the lower limb. Multiple sclerosis was mild in most cases (EDSS 2.2 ± 1.9). The EDSS was less than 4 in 32 cases (86%), between 4 and 6 in 2 (5%), higher than 6.5 in 3 (8%).

AB - We evaluated the risk of developing clinically definite multiple sclerosis (CDMS) after an acute attack of isolated optic neuritis (ON) in 112 patients, in relation to demographic and paraclinical findings. Patients were examined by brain MRI, CSF analysis, and multiple evoked potentials (EPs); 10 were lost to follow-up, and the other 102 were enrolled in a prospective study (follow-up duration 6.3 ± 2.2 years). Of these, 37 (36.3%) developed CDMS after a mean interval of 2.3 ± 1.6 years. The risk of developing CDMS was 13% after 2 years, 30% after 4, 37% after 6, and 42% after 8 and 10 years. Gender, age, and season of ON onset did not affect the risk. MS occurred in 37 of 71 patients (52.1%) with one MRI lesion or more; no patient with a normal MRI developed the disease. MS developed more frequently in patients with intrathecal IgG synthesis than in those without (43% vs. 28%), but the difference was not statistically significant. Multiple EPs showed a slight predictive value only including somatosensory EPs of the lower limb. Multiple sclerosis was mild in most cases (EDSS 2.2 ± 1.9). The EDSS was less than 4 in 32 cases (86%), between 4 and 6 in 2 (5%), higher than 6.5 in 3 (8%).

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KW - Oligoclonal bands

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