Optic neuritis in Turkish children and adolescents: A multicenter retrospective study

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dc.authoridDundar, Nihal Olgac/0000-0002-5902-3501
dc.authoridGUL MERT, GULEN/0000-0002-1160-5617
dc.authoridDokurel Çetin, İpek/0000-0002-1820-8980
dc.authoridBektas, Omer/0000-0002-2514-8461
dc.authoridYILMAZ, ÜNSAL/0000-0002-7256-8557
dc.authoridYılmaz, Deniz/0000-0003-4570-9067
dc.authoridYıldırım, Miraç/0000-0002-0215-1043
dc.authorwosidDundar, Nihal Olgac/AAF-9861-2021
dc.authorwosidGUL MERT, GULEN/J-4594-2018
dc.authorwosidDokurel Çetin, İpek/KVB-4100-2024
dc.authorwosidBektas, Omer/AEA-6743-2022
dc.authorwosidYILMAZ, ÜNSAL/ABG-7549-2021
dc.authorwosidYılmaz, Deniz/ABB-3640-2020
dc.authorwosidGENCPINAR, PINAR/KHY-2639-2024
dc.contributor.authorDirek, Meltem Cobanogullari
dc.contributor.authorBesen, Seyda
dc.contributor.authorOncel, Ibrahim
dc.contributor.authorGunbey, Ceren
dc.contributor.authorOzdogan, Orhan
dc.contributor.authorOrgun, Leman Tekin
dc.contributor.authorSahin, Sevim
dc.date.accessioned2024-08-04T20:54:57Z
dc.date.available2024-08-04T20:54:57Z
dc.date.issued2024
dc.departmentİnönü Üniversitesien_US
dc.description.abstractBackground: Various etiologies may underlie optic neuritis, including autoantibody-mediated disorders described in the last decade. We re-examined demographic, clinical, laboratory features and prognostic factors in pediatric patients with autoimmune optic neuritis according to current knowledge.Methods: Cases of pediatric ON from 27 centers in Turkiye diagnosed between 2009 and 2022 were included for retrospective evaluation.Results: The study included 279 patients, 174 females and 105 males, with a female-to-male ratio of 1.65. The average age at onset was 12.8 +/- 3.4 years, and mean follow-up, 2.1 years (range: 1-12.1 years). Patients <10 years old were grouped as prepubertal and those >= 10 years old as others. The diagnoses made at the end of follow-up were multiple sclerosis associated optic neuritis (n = 90, 32.3 %), single isolated optic neuritis (n = 86, 31 %), clinically isolated syndrome (n = 41, 14.7 %), myelin oligodendrocyte glycoprotein antibody associated optic neuritis (n = 22, 7.9 %), and relapsing isolated optic neuritis (n = 18, 6.5 %). Predominant diagnoses were myelin oligodendrocyte glycoprotein antibody associated optic neuritis and acute disseminated encephalomyelitis associated optic neuritis in the prepubertal group and multiple sclerosis associated optic neuritis in the older group. Recurrences were observed in 67 (24 %) patients, including 28 with multiple sclerosis associated optic neuritis, 18 with relapsing isolated optic neuritis, 11 with myelin oligodendrocyte glycoprotein antibody associated optic neuritis, 8 with aquaporin-4 antibody related optic neuritis, and 2 with chronic relapsing inflammatory optic neuropathy. Recurrences were more common among female patients. Findings supporting the diagnosis of multiple sclerosis included age of onset >= 10 years (OR=1.24, p = 0.027), the presence of cranial MRI lesions (OR=26.92, p<0.001), and oligoclonal bands (OR=9.7, p = 0.001). Treatment in the acute phase consisted of intravenous pulse methylprednisolone (n = 46, 16.5 %), pulse methylprednisolone with an oral taper (n = 212, 76 %), and combinations of pulse methylprednisolone, plasmapheresis, or intravenous immunoglobulin (n = 21, 7.5 %). Outcome at 12 months was satisfactory, with 247 out of 279 patients (88.5 %) demonstrating complete recovery. Thirty-two patients exhibited incomplete recovery and further combination treatments were applied. Specifically, patients with relapsing isolated optic neuritis and aquaporin-4 antibody related optic neuritis displayed a less favorable prognosis.Conclusion: Our results suggest optic neuritis is frequently bilateral in prepubertal and unilateral in peri- or postpubertal patients. Age of onset 10 or older, presence of oligoclonal bands, and brain MRI findings reliably predict the development of multiple sclerosis. The risk of developing multiple sclerosis increases mostly during the second and third years of follow-up. Relapsing isolated optic neuritis remains a separate group where the pathogenesis and outcome remain unclear. Investigation of predisposing and diagnostic biomarkers and long follow-up could help to define this group.en_US
dc.identifier.doi10.1016/j.msard.2023.105149
dc.identifier.issn2211-0348
dc.identifier.issn2211-0356
dc.identifier.pmid38096730en_US
dc.identifier.scopus2-s2.0-85180502878en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.urihttps://doi.org/10.1016/j.msard.2023.105149
dc.identifier.urihttps://hdl.handle.net/11616/101739
dc.identifier.volume81en_US
dc.identifier.wosWOS:001138961000001en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevier Sci Ltden_US
dc.relation.ispartofMultiple Sclerosis and Related Disordersen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectPediatric optic neuritisen_US
dc.subjectMultiple sclerosisen_US
dc.subjectMyelin oligodendrocyte glycoprotein antibodyen_US
dc.subjectNeuromyelitis opticaen_US
dc.subjectTreatmenten_US
dc.titleOptic neuritis in Turkish children and adolescents: A multicenter retrospective studyen_US
dc.typeArticleen_US

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