Optic neuritis--a sign of multiple sclerosis or other diseases of the central nervous system.

Abstract

A neurological and ophthalmological re-examination has been carried out of 116 patients with optic neuritis (ON), who were treated at the eye clinic of the Central Hospital of Turku University during the years 1950–1969. The follow-up period of patients varied from 3 to 22 years (average 10.2 years). Fifty-eight (50.0 per cent) had probable MS (Multiple Sclerosis) and 18 (15.5 per cent) possible MS. Thirty-two (42.1 per cent) earlier undiagnosed cases of MS were found in this material. In most of these cases the patients' neurological symptoms were so mild that they had not consulted a neurologist. This indicates that MS is a more common disease than the selective studies based on patients collected from the hospital records in a neurological clinic would suppose. ON with some cause other than MS was observed in 15 (13.0 per cent) patients, among whom were many cases with a neurological disease other than MS. The etiology of ON remained unknown in 25 (21.6 per cent) patients. Many of these patients had some very mild neurological symptoms, but a diagnosis of MS, based on criteria of the Schumacher committee, could not be made. After a longer follow-up period, even these cases can perhaps be classified as suffering from MS. Neurological and ophthalmological findings in re-examined patients are described and compared with previous reports. Six families with occurrence of MS within the family, and two with Leber's hereditary optic atrophy are reported. Our studies indicate that ON must be considered as an important sign of a disease of the central nervous system and not only as an isolated eye disease.