Relapsing Inflammatory Optic Neuropathy: A Multicenter Study of 62 Patients (P07.251)

Abstract

Objective: The aim is to evaluate a multicenter cohort of RON in order to define their characteristics. Background Optic neuritis (ON) may be the first symptom of a central nervous system demyelinating, systemic or infectious diseases. Although ON is frequently limited to a single episode, few patients experience recurrent episodes with a negative workup for multiple sclerosis (MS), neuromyelitis optica (NMO) or other causes. That disorder named relapsing ON (RON), is poorly describe in view of the lack of a large cohort. Medical literature shows 2 forms of RON: chronic relapsing inflammatory ON (CRION) which is a progressive ON relapsing after steroids withdrawal and relapsing inflammatory ON (RION) which is a non-progressive ON without steroids dependence. Design/Methods: 62 patients, retrospectively included, were diagnosed with RON when they have been presented ON relapsing as the only sign, without criteria for MS or NMO, during a follow up of 8 years. Results: The age of onset was 33 years and sex ratio F/M was 3/1. Mean final visual acuity (VA) was 0,71 and mean final retinal nervous fiber layer thickness was 77 μm. Seventy percent of patient with RON presented a RION pattern while 30% presented as CRION. Cohort of RON is composed of aproximately 10% of probable NMO (IgG-AQP4 positive, severity of ON more important), 20% of probable MS (CSF oligoclonal bands positive and MRI abnormalities frequently observed) and 10% of ON related to a systemic disease. 60% of RON are of unknown etiology. We individualized 2 sub-populations with poor long-term visual prognosis : CRION and RON with AQP4-antibodies. In contrast, more than 70% of RION without AQP4-antibodies have a visual acuity higher than 0,8 at the end of the follow up. Conclusions: RON is probably a separate entity corresponding to an autoimmune disease different to MS, NMO or vasculitis. Disclosure: Dr. Benoilid has nothing to disclose. Dr. Tilikete has nothing to disclose. Dr. Arndt has nothing to disclose. Dr. Collongues has received personal compensation for activities with Biogen Idec, Bayer Schering Pharma, Teva Neuroscience, Merck-Serono, Sanofi-Aventis Pharmaceuticals, Inc., and Novartis. Dr. Vighetto has nothing to disclose. Dr. Vignal-Clermont has nothing to disclose. Dr. De Seze has received personal compensation for activities with Bayer Schering, Biogen Idec, LFB, Merck Serono, Novartis, Sanofi-Aventis, and Teva Neuroscience.Dr. De Seze has received personal compensation in an editorial capacity for Elsevier.