OBJECTIVE: To assess the risk of developing multiple sclerosis (MS) after optic neuritis and the factors predictive of high and low risk. DESIGN:Subjects in the Optic Neuritis Treatment Trial, who were enrolled between July 1, 1988, and June 30, 1991, were followed up prospectively for 15 years, with the final examination in 2006. SETTING:Neurologic and ophthalmologic examinations at 13 clinical sites. PARTICIPANTS: Three hundred eighty-nine subjects with acute optic neuritis. MAIN OUTCOME MEASURES: Development of MS and neurologic disability assessment. RESULTS: The cumulative probability of developing MS by 15 years after onset of optic neuritis was 50% (95% confidence interval, 44%-56%) and strongly related to presence of lesions on a baseline non-contrast-enhanced magnetic resonance imaging (MRI) of the brain. Twenty-five percent of patients with no lesions on baseline brain MRI developed MS during follow-up compared with 72% of patients with 1 or more lesions. After 10 years, the risk of developing MS was very low for patients without baseline lesions but remained substantial for those with lesions. Among patients without lesions on MRI, baseline factors associated with a substantially lower risk for MS included male sex, optic disc swelling, and certain atypical features of optic neuritis. CONCLUSIONS: The presence of brain MRI abnormalities at the time of an optic neuritis attack is a strong predictor of the 15-year risk of MS. In the absence of MRI-detected lesions, male sex, optic disc swelling, and atypical clinical features of optic neuritis are associated with a low likelihood of developing MS. This natural history information is important when considering prophylactic treatment for MS at the time of a first acute onset of optic neuritis.
RCT Entities:
OBJECTIVE: To assess the risk of developing multiple sclerosis (MS) after optic neuritis and the factors predictive of high and low risk. DESIGN: Subjects in the Optic Neuritis Treatment Trial, who were enrolled between July 1, 1988, and June 30, 1991, were followed up prospectively for 15 years, with the final examination in 2006. SETTING: Neurologic and ophthalmologic examinations at 13 clinical sites. PARTICIPANTS: Three hundred eighty-nine subjects with acute optic neuritis. MAIN OUTCOME MEASURES: Development of MS and neurologic disability assessment. RESULTS: The cumulative probability of developing MS by 15 years after onset of optic neuritis was 50% (95% confidence interval, 44%-56%) and strongly related to presence of lesions on a baseline non-contrast-enhanced magnetic resonance imaging (MRI) of the brain. Twenty-five percent of patients with no lesions on baseline brain MRI developed MS during follow-up compared with 72% of patients with 1 or more lesions. After 10 years, the risk of developing MS was very low for patients without baseline lesions but remained substantial for those with lesions. Among patients without lesions on MRI, baseline factors associated with a substantially lower risk for MS included male sex, optic disc swelling, and certain atypical features of optic neuritis. CONCLUSIONS: The presence of brain MRI abnormalities at the time of an optic neuritis attack is a strong predictor of the 15-year risk of MS. In the absence of MRI-detected lesions, male sex, optic disc swelling, and atypical clinical features of optic neuritis are associated with a low likelihood of developing MS. This natural history information is important when considering prophylactic treatment for MS at the time of a first acute onset of optic neuritis.
Authors: E M Frohman; E Havrdova; F Lublin; F Barkhof; A Achiron; M K Sharief; O Stuve; M K Racke; L Steinman; H Weiner; M Olek; R Zivadinov; J Corboy; C Raine; G Cutter; J Richert; M Filippi Journal: Arch Neurol Date: 2006-04
Authors: C M Poser; D W Paty; L Scheinberg; W I McDonald; F A Davis; G C Ebers; K P Johnson; W A Sibley; D H Silberberg; W W Tourtellotte Journal: Ann Neurol Date: 1983-03 Impact factor: 10.422
Authors: Roy W Beck; Jonathan D Trobe; Pamela S Moke; Robin L Gal; Dongyuan Xing; M Tariq Bhatti; Michael C Brodsky; Edward G Buckley; Georgia A Chrousos; James Corbett; Eric Eggenberger; James A Goodwin; Barrett Katz; David I Kaufman; John L Keltner; Mark J Kupersmith; Neil R Miller; Sarkis Nazarian; Silvia Orengo-Nania; Peter J Savino; William T Shults; Craig H Smith; Michael Wall Journal: Arch Ophthalmol Date: 2003-07
Authors: Peter A Brex; Olga Ciccarelli; Jonathon I O'Riordan; Michael Sailer; Alan J Thompson; David H Miller Journal: N Engl J Med Date: 2002-01-17 Impact factor: 91.245
Authors: W I McDonald; A Compston; G Edan; D Goodkin; H P Hartung; F D Lublin; H F McFarland; D W Paty; C H Polman; S C Reingold; M Sandberg-Wollheim; W Sibley; A Thompson; S van den Noort; B Y Weinshenker; J S Wolinsky Journal: Ann Neurol Date: 2001-07 Impact factor: 10.422
Authors: Henrik Horwitz; Matilda Degn; Signe Modvig; Henrik B W Larsson; Benedikte Wanscher; Jette L Frederiksen Journal: J Neurol Date: 2012-06-06 Impact factor: 4.849
Authors: Grazyna Adamus; Lori Brown; Shayne Andrew; Roberto Meza-Romero; Gregory G Burrows; Arthur A Vandenbark Journal: Invest Ophthalmol Vis Sci Date: 2012-01-25 Impact factor: 4.799
Authors: Muhammad Taimur Malik; Brian C Healy; Leslie A Benson; Pia Kivisakk; Alexander Musallam; Howard L Weiner; Tanuja Chitnis Journal: Neurology Date: 2014-05-21 Impact factor: 9.910
Authors: Robert L Harrigan; Andrew J Plassard; Louise A Mawn; Robert L Galloway; Seth A Smith; Bennett A Landman Journal: Proc SPIE Int Soc Opt Eng Date: 2015-03-20