Clinical Features and Outcomes of Pediatric Monophasic and Recurrent Idiopathic Optic Neuritis

Abstract

Limited data exist on isolated optic neuritis in children. We report the clinical features and treatment of pediatric subjects with monophasic and recurrent idiopathic optic neuritis. This retrospective cohort study of patients with isolated optic neuritis identified 10 monophasic and 7 recurrent optic neuritis cases. Monophasic optic neuritis patients were older (mean 13.3 ± 4.22) than those with recurrent idiopathic optic neuritis (9.86 ± 3.63). Females represented 50% of monophasic and 85.7% of recurrent idiopathic optic neuritis cases. Patients with monophasic optic neuritis were less likely to have a bilateral onset than recurrent idiopathic optic neuritis (40% vs 57.1%). Only 1 case had oligoclonal bands in the cerebrospinal fluid CSF. Most recurrent idiopathic optic neuritis cases had evidence of anti–myelin oligodendrocyte glycoprotein (MOG) antibodies (5/7). Treatment of recurrent idiopathic optic neuritis cases included intravenous pulse glucocorticosteroids and immunotherapy. We observed differences between recurrent and monophasic idiopathic optic neuritis. Immunosuppression appeared to prevent further relapses in recurrent idiopathic optic neuritis patients. Weaning immunotherapies after several years of quiescence in recurrent idiopathic optic neuritis may be possible, but larger studies are needed.

Neuromyelitis optica spectrum disorder after presumed coronavirus (COVID-19) infection: A case report

“…Limited data exist on pediatric-onset optic neuritis. The incidence of optic neuritis in children is estimated around 1-5 per 100.000 per year ( Jonzzon et al., 2020 ). To confirm the diagnosis, serum detection for antibodies against AQP4-IgG and MOG-IgG should be done.…”

Age-dependent favorable visual recovery despite significant retinal atrophy in pediatric MOGAD: how much retina do you really need to see well?

“…Although the histopathology of cerebral lesions in MOGAD patients demonstrates relative preservation of axonal structures, severe visual impairment or functional blindness have been reported in >30% of MOGAD adults ON patients, and OCT studies repeatedly demonstrated profound axonal degeneration with loss of retinal ganglion cells [ 11 – 14 ]. Although MOG-IgG antibodies have been frequently reported in children with ON, there are only a few studies investigating retinal changes and visual outcomes in this population [ 5 , 15 – 17 ]. Moreover, there are no studies comparing ON course and outcome in children and adults with MOGAD.…”

State of Regional Hemodynamics and Level of Adaptation of the Cardiovascular System in Patients With Optic Neuritis

“…It is important to be able to correct the manifestations of the ischemic process and trophic disorders in time. The pathophysiology and natural course of idiopathic optic neuritis are insufficiently studied [10]. The chronic ischemia leads to diffuse death of axons [11].…”