Please use this identifier to cite or link to this item: https://hdl.handle.net/11499/56549
Title: Optic neuritis in Turkish children and adolescents: A multicenter retrospective study
Authors: Direk, M.Ç.
Besen, Ş.
Öncel, İ.
Günbey, C.
Özdoğan, O.
Orgun, L.T.
Sahin, S.
Cansu, Ali
Yıldız, Nihal
Kanmaz, Seda
Yılmaz, Sanem
Tekgül, Hasan
Türkdoğan, Dilşad
Ünver, Olcay
Thomas, Gülten Öztürk
Başıbüyük, Salih
Yılmaz, Deniz
Kurt, Ayşegül Neşe
Gültutan, Pembe
Özsoy, Özlem
Yiş, Uluç
Kurul, Semra Hız
Güngör, Serdal
Özgör, Bilge
Karadağ, Meral
Dündar, Nihal Olgaç
Gençpınar, Pınar
Bildik, Olgay
Orak, Sibğatullah Ali
Kabur, Çişil Çerçi
Kara, Bülent
Karaca, Ömer
Canpolat, Mehmet
Gümüş, Hakan
Per, Hüseyin
Yılmaz, Ünsal
Karaoğlu, Pakize
Ersoy, Özlem
Tosun, Ayşe
Öztürk, Semra Büyükkorkmaz
Yüksel, Deniz
Atasoy, Ergin
Gücüyener, Kıvılcım
Yıldırım, Miraç
Bektaş, Ömer
Çavuşoğlu, Dilek
Yarar, Çoşkun
Güngör, Olcay
Mert, Gülen Gül
Sarıgeçili, Esra
Edizer, Selvinaz
Çetin, İpek Dokurel
Aydın, Seren
Diler, Betül
Özdemir, Asena Ayça
Erol, İlknur
Okuyaz, Çetin
Anlar, Banu
Keywords: Multiple sclerosis
Myelin oligodendrocyte glycoprotein antibody
Neuromyelitis optica
Pediatric optic neuritis
Treatment
methylprednisolone
myelin oligodendrocyte glycoprotein
protein antibody
adolescent
adolescent health
Article
child
child health
clinical evaluation
clinical feature
convalescence
demography
disease association
disease predisposition
drug effect
drug pulse therapy
female
follow up
human
major clinical study
male
multicenter study (topic)
multiple sclerosis
nuclear magnetic resonance imaging
onset age
optic neuritis
prognosis
recurrent disease
retrospective study
risk assessment
sex ratio
trend study
Turk (people)
Publisher: Elsevier B.V.
Abstract: Background: 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 Türkiye 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. © 2023 Elsevier B.V.
URI: https://doi.org/10.1016/j.msard.2023.105149
https://hdl.handle.net/11499/56549
ISSN: 2211-0348
Appears in Collections:PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection
Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection
Tıp Fakültesi Koleksiyonu
WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection

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