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Assessment of Pediatric Optic Neuritis Visual Acuity Outcomes at 6 Months
- Source :
- JAMA ophthalmology. 138(12)
- Publication Year :
- 2020
-
Abstract
- Importance Optic neuritis (ON) in children is uncommon. There are limited prospective data for visual acuity (VA) outcomes, associated diseases, and neuroimaging findings. Prospective data from a large sample would be useful for counseling families on treatment decisions and prognosis. Objective To prospectively study children with a first episode of ON, describe VA after 6 months, and ascertain the network's (Pediatric Eye Disease Investigator Group and Neuro-Ophthalmology Research Disease Investigator Consortium) ability to enroll pediatric patients with ON prospectively. Design, Setting, and Participants This nonrandomized cohort study was conducted from September 20, 2016, to July 20, 2018, at 23 sites in the United States and Canada in pediatric ophthalmology or neuro-ophthalmology clinics. A total of 44 children (aged 3-15 years) presented with a first episode of ON (visual loss, pain on eye movements, or both) within 2 weeks of symptom onset and at least 1 of the following in the affected eye: a distance high-contrast VA (HCVA) deficit of at least 0.2 logMAR below age-based norms, diminished color vision, abnormal visual field, or optic disc swelling. Exclusion criteria included preexisting ocular abnormalities or a previous episode of ON. Main Outcomes and Measures Primary outcomes were monocular HCVA and low-contrast VA at 6 months. Secondary outcomes were neuroimaging, associated diagnoses, and antibodies for neuromyelitis optica and myelin oligodendrocyte glycoprotein. Results A total of 44 children (mean age [SD], 10.2 [3.5] years; 26 boys [59%]; 23 White individuals [52%]; 54 eyes) were enrolled in the study. Sixteen patients (36%) had bilateral ON. Magnetic resonance imaging revealed white matter lesions in 23 children (52%). Of these children, 8 had myelin oligodendrocyte glycoprotein-associated demyelination (18%), 7 had acute disseminated encephalomyelitis (16%), 5 had multiple sclerosis (11%), and 3 had neuromyelitis optica (7%). The baseline mean HCVA was 0.95 logMAR (20/200), which improved by a mean 0.76 logMAR (95% CI, 0.54-0.99; range, -0.70 to 1.80) to 0.12 logMAR (20/25) at 6 months. The baseline mean distance low-contrast VA was 1.49 logMAR (20/640) and improved by a mean 0.72 logMAR (95% CI, 0.54-0.89; range, -0.20 to 1.50) to 0.73 logMAR (20/100) at 6 months. Baseline HCVA was worse in younger participants (aged
- Subjects :
- Male
Pediatrics
medicine.medical_specialty
Canada
Visual acuity
Optic Neuritis
genetic structures
Adolescent
Eye disease
Visual Acuity
01 natural sciences
White People
Neuro-ophthalmology
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Optic neuritis
Prospective Studies
0101 mathematics
Child
First episode
Neuromyelitis optica
business.industry
010102 general mathematics
medicine.disease
Magnetic Resonance Imaging
eye diseases
United States
Acid Sensing Ion Channels
Ophthalmology
Child, Preschool
030221 ophthalmology & optometry
Pediatric ophthalmology
Female
medicine.symptom
business
Cohort study
Subjects
Details
- ISSN :
- 21686173
- Volume :
- 138
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- JAMA ophthalmology
- Accession number :
- edsair.doi.dedup.....b37a503ae20e7041bc38a9e323b0ee24