Abstract

P 071

Optic neuritis in pediatric patients – clinical evaluations of the 10-year follow-up

Autrata R.¹, Helmanová I.¹, Pyrochtová S.¹, Ošlejšková H.², Vondráček P.², Skotáková J.^3
1Department of Pediatric Ophthalmology, ²Department of Pediatric Neurology, ³Department of Pediatric Radiology, Masaryk University Hospital, Brno, Czech Republic

Objective: To analyse the clinical manifestations, etiology, management and long-term visual results in children with optic neuritis.
Methods: The retrospective study involve consecutive pediatric patients with optic neuritis treated in our university clinic during a 10-year period (1995 – 2005). Fourty-three pediatric patients (69 eyes) with the mean age 11.6 years (range: 4 to 18 years) were included in the study. The mean follow-up was 4.7 years. The degree of initial visual loss, defects of visual field and color vision, abnormalities of visual evoked potentials, subsequent visual recovery, associated diseases and etiology, MRI and CSF analysis were evaluated. The efects of high-dose methylprednisolone or/ and intravenous immunogobulin were reviewed.
Results: Twenty-six patients (63%) had bilateral optic neuritis, and 17 patients (37%) had unilateral disease. Fifty-one of 69 eyes (74%) had visual acuity of 20/200 or less at the first clinical presentation. 48 of 69 eyes (70%) recovered visual acuity 20/40 or better, 16 of 69 eyes (21%) in the range of 20/50 to 20/125, and five of 69 eyes (7%) recovered vision of 20/200 or less. No etiology was found in 14 children (33%), 29 patients had systemic disease. A normal MRI of the brain was associated with visual recovery of 20/40 or better in 12 of 14 affected children. Visual evoked potentials (VEP) in acute phase were abnormal in 47of 52 (91%) affected eyes at bilateral cases and 17eyes (100%) of monolateral ON. At final follow-up, complete VEP recovery occurred in 41 of 64 eyes (64%) with initially abnormal VEP.
Conclusions: Optic neuritis in our children was associated with a high recovery rate of all clinical parameters and good visual recovery, but 28% of affected eyes remain visually disabled. Younger patients than 7years of age are more likely to have bilateral disease and more favourable visual outcome than in older children.

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