Conversion of idiopathic demyelinating optic neuritis to multiple sclerosis: its rate and risks
10.3760/cma.j.issn.1006-7876.2009.01.007
- VernacularTitle:特发性脱髓鞘性视神经炎的临床转归
- Author:
Xiaojun ZHANG
;
Jingting PENG
;
Nan JIA
- Publication Type:Journal Article
- Keywords:
Optic neuritis;
Multiple sclerosis;
Neuromyelitis optica;
Magnetic resonance imaging
- From:
Chinese Journal of Neurology
2009;42(1):20-24
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical prognosis of idiopathic demyelinating optic neuritis (IDON), the rate of its conversion to multiple sclerosis (MS) or neuromyelitis optica (NMO) and its clinical features related to the conversion.Methods Patients satisfying our entry criteria for IDON hospitalized in Beijing Tongren Hospital during the period from 2002 to 2007 were re-evaluated with follow-ups for 6-months to 5-years.The McDonald diagnostic criteria for MS (revised, 2005) was used to diagnose MS in these subjects during follow-up and the diagnosis of NMO utilized 1999 Wingerchuk' s NMO criteria.The Chi-Squared χ2 test was applied to statistically analyze association of clinical features and development of MS or NMO.Results In 107 recruited IDON cases with complete clinical data and follow-up, 12 cases (11.2%) developed into MS or NMO during follow-up period.All 12 cases met the revised McDonald criteria, of which 4 cases met NMO criteria and the remaining eight cases showed some clinical evidence of "optic-spinal MS (OS-MS)".A significantly higher conversion rate of 23.1% was found in recurrent IDON than the 4.4% in single-episode cases (χ2 = 6.899, P < 0.01) .Convesion rate of female patiends (17.2%) is significantly higher than male patients (4.1%, χ2 = 4.620, P < 0.05).Conversion rate of 18.2% in patients with initially abnormal brain MRI was higher than rate of 8.1% in cases with normal brain MRI, but the difference was not statistically significant.No difference was found between presence or absence of swollen disc, nor severity of vision loss.Conclusions In a group of IDON patients, 11.2% developed into MS and NMO or clinically indicative OS-MS.Recurrent IDON and female gender suggested higher risk of developing MS or NMO.
