The 5-year risk of MS after optic neuritis

The objective of our study was to assess the 5-year risk of and prognostic factors for the development of clinically definite multiple sclerosis (CDMS) following optic neuritis. In a prospective cohort study design, 388 patients, who did not have probable or definite MS at study entry enrolled in the Optic Neuritis Treatment Trial between 1988 and 1991, and were followed for the development of CDMS. The 5-year cumulative probability of CDMS was 30% and did not differ by treatment group. Neurologic impairment in the patients who developed CDMS was generally mild. Brain MRI performed at study entry was a strong predictor of CDMS, with the 5-year risk of CDMS ranging from 16% in the 202 patients with no MRI lesions to 51% in the 89 patients with three or more MRI lesions. Independent of brain MRI, the presence of prior nonspecific neurologic symptoms was also predictive of the development of CDMS. Lack of pain, the presence of optic disk swelling, and mild visual acuity loss were features of the optic neuritis associated with a low risk of CDMS among the 189 patients who had no brain MRI lesions and no history of neurologic symptoms or optic neuritis in the fellow eye. The 5-year risk of CDMS following optic neuritis is highly dependent on the number of lesions present on brain MRI. However, even a normal brain MRI does not preclude the development of CDMS. In these patients with no brain MRI lesions, certain clinical features identify a subgroup with a particularly low 5-year risk of CDMS.

[1]  N. Mantel.  Evaluation of survival data and two new rank order statistics arising in its consideration. , 1966, Cancer chemotherapy reports.

[2]  G. Beebe,et al.  STUDIES ON THE NATURAL HISTORY OF MULTIPLE SCLEROSIS , 1966, Acta neurologica Scandinavica.

[3]  O. Andersen,et al.  Prognostic factors in a multiple sclerosis incidence cohort with twenty-five years of follow-up. , 1993, Brain : a journal of neurology.

[4]  R. Priore,et al.  Correlation of clinical, magnetic resonance imaging, and cerebrospinal fluid findings in optic neuritis , 1997, Annals of neurology.

[5]  R. Beck,et al.  The effect of corticosteroids for acute optic neuritis on the subsequent development of multiple sclerosis. The Optic Neuritis Study Group. , 1993, The New England journal of medicine.

[6]  John P. Mitchell,et al.  Microangiopathy of Brain, Retina, and Inner Ear , 1995, Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society.

[7]  R. Griggs.  Changes in policy for publishing manuscripts in Neurology , 1997, Neurology.

[8]  J. Olesen,et al.  Magnetic resonance imaging of the brain in patients with acute monosymptomatic optic neuritis , 1989, Acta neurologica Scandinavica.

[9]  M. Brodsky,et al.  Visual function 5 years after optic neuritis: Experience of the optic neuritis treatment trial , 1997 .

[10]  D.,et al.  Regression Models and Life-Tables , 2022 .

[11]  '. W.M.HUTCHINSON,et al.  Acute optic neuritis and the prognosis for multiple sclerosis. , 1976, Journal of neurology, neurosurgery, and psychiatry.

[12]  W. Mcdonald,et al.  A reassessment of the risk of multiple sclerosis developing in patients with optic neuritis after extended follow-up. , 1987, Journal of neurology, neurosurgery, and psychiatry.

[13]  D. Li,et al.  Magnetic resonance imaging of the head in the diagnosis of multiple sclerosis: A prospective 2‐year follow‐up with comparison of clinical evaluation, evoked potentials, oligoclonal banding, and CT , 1991, Neurology.

[14]  M. O’Connor,et al.  EFFECT OF OLIGEMIA ON REGIONAL METABOLITE LEVELS IN CAT BRAIN , 1978, Journal of Neurochemistry.

[15]  R. Beck,et al.  Brain magnetic resonance imaging in acute optic neuritis. Experience of the Optic Neuritis Study Group. , 1993, Archives of neurology.

[16]  W. I. McDonald,et al.  Quantitative brain MRI lesion load predicts the course of clinically isolated syndromes suggestive of multiple sclerosis , 1994, Neurology.

[17]  F. Munschauer,et al.  Clinical and magnetic resonance imaging in optic neuritis , 1991, Neurology.

[18]  S. Holtås,et al.  A long‐term prospective study of optic neuritis: Evaluation of risk factors , 1990, Annals of neurology.

[19]  M. Alter,et al.  Optic neuritis in relation to multiple sclerosis , 1976, Journal of Neurology.

[20]  J. Baskerville,et al.  The natural history of multiple sclerosis: a geographically based study. 7. Progressive-relapsing and relapsing-progressive multiple sclerosis: a re-evaluation. , 1999, Brain : a journal of neurology.

[21]  G. Comi,et al.  Paraclinical tests in acute‐onset optic neuritis: basal data and results of a short follow‐up , 1991, Acta neurologica Scandinavica.

[22]  R. Beck,et al.  Design, methods, and conduct of the Optic Neuritis Treatment Trial. , 1993, Controlled clinical trials.

[23]  J. Gilbert,et al.  Duchenne muscular dystrophy , 1988, Neurology.

[24]  J. Rizzo,et al.  Risk of developing multiple sclerosis after uncomplicated optic neuritis , 1988, Neurology.

[25]  D. Miller,et al.  The significance of brain magnetic resonance imaging abnormalities at presentation with clinically isolated syndromes suggestive of multiple sclerosis. A 5-year follow-up study. , 1993, Brain : a journal of neurology.

[26]  P. O'Connor.  Acute optic neuritis: prognosis for the development of multiple sclerosis. , 1979, Aeromedical reviews.

[27]  D. Silberberg,et al.  New diagnostic criteria for multiple sclerosis: Guidelines for research protocols , 1983, Annals of neurology.

[28]  Neil R. Miller,et al.  A Randomized, Controlled Trial of Corticosteroids in the Treatment of Acute Optic Neuritis , 1992 .

[29]  C. Lucchinetti,et al.  Risk factors for developing multiple sclerosis after childhood optic neuritis , 1997, Neurology.

[30]  R. Beck,et al.  The Optic Neuritis Treatment Trial: Putting the Results in Perspective , 1995 .

[31]  J. Kurtzke.  Rating neurologic impairment in multiple sclerosis , 1983, Neurology.

[32]  J. Mcleod,et al.  Acute optic neuritis: a prospective study of risk factors for multiple sclerosis. , 1986, Journal of neurology, neurosurgery, and psychiatry.