METHODS: In this observational study, children with the first clinical event of optic neuritis at an age less than 18 years were evaluated. High-contrast visual acuity, colour vision, Expanded Disability Status Scale (EDSS), Anti-MOG and AQP-4 antibodies were assessed.
RESULTS: Of the 55 screened, 45 children (77 eyes), median age-98 months, 30 (67%) bilateral were enrolled. Fifty of 77 eyes (67%) had Snellen visual acuity less than 6/60. Twelve children (27%) were MOG seropositive and 3 had AQP-4 positivity. At median follow up of 35 months, 10 (22%) children had one or more relapses. At follow up, the median (IQR) visual acuity improved from nadir of 2.1 (1-2.7) logMAR to 0 (0-0.18) logMAR and 64/77 eyes (83%) had visual recovery. The diagnosis at last follow up was isolated ON in 39/45 (86.6%), relapsing ON (5, 11%), AQP-4 positive NMOSD (3, 7%), MOG antibody associated demyelination (12, 27%), dual seronegative ON (30,67%) and Multiple sclerosis (1, 2%).
CONCLUSIONS: Most children with first demyelinating event as ON have a monophasic illness. Despite severe acute-phase visual loss, most eyes with ON will recover good visual functions. The risk of AQP-4 disease and multiple sclerosis is low in this group.
方法:在这项观察性研究中,我们对年龄小于18岁时首次发生视神经炎临床事件的儿童进行了评估.高对比度视力,色觉,扩展的残疾状态量表(EDSS),评估抗MOG和AQP-4抗体。
结果:在55个筛选中,45名儿童(77眼)中位年龄-98个月,30例(67%)双边入组。77只眼中的50只(67%)具有小于6/60的Snellen视敏度。12名儿童(27%)MOG血清阳性,3名AQP-4阳性。在中位随访35个月时,10名(22%)儿童有一次或多次复发。在跟进时,中位(IQR)视力从最低点2.1(1-2.7)logMAR提高至0(0-0.18)logMAR,64/77眼(83%)视力恢复.末次随访诊断为39/45(86.6%),复发(5,11%),AQP-4阳性NMOSD(3,7%),MOG抗体相关脱髓鞘(12,27%),双血清阴性ON(30,67%)和多发性硬化症(1,2%)。
结论:大多数首次脱髓鞘事件为ON的儿童患有单相疾病。尽管严重的急性期视力丧失,大多数开的眼睛会恢复良好的视觉功能。这一组患AQP-4疾病和多发性硬化的风险较低。