Visual Outcomes and Clinical Manifestations of Pediatric Optic Neuritis in Indian Population: An Institutional Study
- PMID: 29554001
- DOI: 10.1097/WNO.0000000000000646
Visual Outcomes and Clinical Manifestations of Pediatric Optic Neuritis in Indian Population: An Institutional Study
Abstract
Background: Optic neuritis in children is an uncommon disorder which usually occurs after a viral illness or vaccination and, less frequently, occurs as a manifestation of a demyelinating disorder. Pediatric optic neuritis usually is bilateral and presents with optic disc edema, recovers rapidly with steroid therapy, and generally has low conversion rate to multiple sclerosis or neuromyelitis optica spectrum disorder. We report the clinical features and treatment outcomes of pediatric optic neuritis in Indian population, for which little data are available.
Methods: We reviewed the medical case records of patients with optic neuritis who were younger than 18 years, from 1999 to 2016. All patients were assessed and managed in the Neuro-Ophthalmology Department of Sankara Nethralaya, a unit of Medical Research Foundation and Pediatric Neurology Department of Kanchi Kamakoti-Childs Trust Hospital, Chennai, India.
Results: One hundred seventeen eyes of 78 children with mean age of 11.84 (±4.58) years were identified. Forty-two (53.8%) were females and 36 (46.2%) were males. Thirty-nine patients (50%) had bilateral involvement and a similar number had unilateral involvement. Fifty-nine eyes (50.4%) had optic disc edema, 20 eyes (17.1%) had disc pallor, and 38 eyes (32.4%) had normal discs. Of 63 patients who had neuroimaging, 36 had MRI, and 27 underwent computed tomography. Eighty-four eyes (of 59 patients) received steroid therapy according to the protocol of the Optic Neuritis Treatment Trial (ONTT). Thirty-three eyes that were treated with other steroid protocols were excluded from the final visual outcome analyses. Sixty of the 84 eyes (72.3%) recovered visual acuity of 20/40 or better. Visual acuity improvement was statistically significant between initial and final visual acuity (logMAR) in our patients treated with the ONTT protocol (P ≤ 0.001).
Conclusions: Our Indian pediatric population had good visual recovery after steroid treatment for optic neuritis. Profound loss of visual acuity on presentation and bilateral involvement were significantly associated with poor visual outcome.
Similar articles
-
Clinical profile and neuroimaging in pediatric optic neuritis in Indian population: A case series.Indian J Ophthalmol. 2017 Mar;65(3):242-245. doi: 10.4103/ijo.IJO_939_16. Indian J Ophthalmol. 2017. PMID: 28440255 Free PMC article.
-
Optic neuritis in children: clinical features and visual outcome.J AAPOS. 1999 Apr;3(2):98-103. doi: 10.1016/s1091-8531(99)70078-9. J AAPOS. 1999. PMID: 10221803
-
Optic neuritis in children.J Pediatr Ophthalmol Strabismus. 2000 Sep-Oct;37(5):254-9. J Pediatr Ophthalmol Strabismus. 2000. PMID: 11020105
-
Pediatric Optic Neuritis.Semin Pediatr Neurol. 2017 May;24(2):122-128. doi: 10.1016/j.spen.2017.04.004. Epub 2017 Apr 10. Semin Pediatr Neurol. 2017. PMID: 28941527 Review.
-
Systemic lupus erythematosus-associated optic neuritis: clinical experience and literature review.Acta Ophthalmol. 2009 Mar;87(2):204-10. doi: 10.1111/j.1755-3768.2008.01193.x. Epub 2008 May 27. Acta Ophthalmol. 2009. PMID: 18507726 Review.
Cited by
-
Characteristics of Optic Neuritis in South Korean Children and Adolescents: A Retrospective Multicenter Study.J Ophthalmol. 2022 Sep 7;2022:4281772. doi: 10.1155/2022/4281772. eCollection 2022. J Ophthalmol. 2022. PMID: 36119139 Free PMC article.
-
Clinical features and visual outcome of pediatric optic neuritis.Indian J Ophthalmol. 2023 Jun;71(6):2603-2604. doi: 10.4103/IJO.IJO_440_23. Indian J Ophthalmol. 2023. PMID: 37322693 Free PMC article. No abstract available.
-
Management and outcomes of pediatric optic neuritis in a tertiary hospital in Riyadh, Saudi Arabia: a retrospective study.BMC Neurol. 2024 Dec 5;24(1):474. doi: 10.1186/s12883-024-03982-9. BMC Neurol. 2024. PMID: 39639219 Free PMC article.
-
Update on pediatric optic neuritis.Curr Opin Ophthalmol. 2019 Nov;30(6):418-425. doi: 10.1097/ICU.0000000000000607. Curr Opin Ophthalmol. 2019. PMID: 31433309 Free PMC article. Review.
-
Working up a child with demyelinating optic neuritis: Striking a balance!Oman J Ophthalmol. 2021 Jun 28;14(2):74-77. doi: 10.4103/ojo.ojo_105_21. eCollection 2021 May-Aug. Oman J Ophthalmol. 2021. PMID: 34345139 Free PMC article. Review.
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical