Abstract
Objective This study aims to describe the clinical manifestations and outcomes in a cohort of older Chinese patients. Method A retrospective study of patients aged ≥ 45 years who had a first episode of optic neuritis (ON) between May 2008 and November 2012. Clinical features at onset and last follow-up were analyzed within subgroups (age 45–65 years and age ≥ 65 years). Results 76 patients (99 eyes) were included, of which 58% were females. The mean age at presentation was 55.53 ± 8.29 years (range: 45–83 years). Vision loss was severe at presentation, with initial best corrected vision activity (BCVA) < 20/200 in 93% and final BCVA < 20/200 in 53% of patients at 5-year follow-up. Final BCVA significantly correlated with the initial BCVA and peripapillary retinal nerve fiber layer. At last follow-up, 14.5% were diagnosed with neuromyelitis optica spectrum disorder (NMOSD), 1.3% were diagnosed with multiple sclerosis (MS), 5.2% with chronic relapsing inflammatory optic neuropathy, 1.3% with infectious ON, and 19.7% with autoimmune ON. None of the elderly group (≥65 years) developed NMOSD or MS. Conclusion Chinese patients in the age group ≥ 65 years with ON are less likely to develop NMOSD or MS. Notwithstanding, they had more severe visual loss at onset and poor recovery.
Highlights
Optic neuritis (ON) is the most common inflammatory demyelinating neuropathy [1]
It has been identified that neuromyelitis optica spectrum disorders (NMOSD) is more likely to develop in Asia, whereas multiple sclerosis (MS) is more prevalent in western countries [7]
This retrospective study included patients evaluated for a first episode of optic neuritis in the Neuro-ophthalmology Clinic of the Chinese PLA General Hospital (PLAGH) in Beijing between May 2008 and November 2012
Summary
Optic neuritis (ON) is the most common inflammatory demyelinating neuropathy [1]. It can manifest as either an isolated episode or be caused as a result of the patient suffering from multiple sclerosis (MS) or neuromyelitis optica spectrum disorders (NMOSD) [2, 3].The optic neuritis treatment trial (ONTT) studied patients between 18 and 45 years old with acute, unilateral optic neuritis; most of whom had good vision recovery [4]. Optic neuritis (ON) is the most common inflammatory demyelinating neuropathy [1]. It can manifest as either an isolated episode or be caused as a result of the patient suffering from multiple sclerosis (MS) or neuromyelitis optica spectrum disorders (NMOSD) [2, 3]. The optic neuritis treatment trial (ONTT) studied patients between 18 and 45 years old with acute, unilateral optic neuritis; most of whom had good vision recovery [4]. This has been classified as typical ON [5]. AfricanAmerican patients were found to have more severe vision loss and less vision recovery [9]
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