Visual Outcomes and Clinical Manifestations of Pediatric Optic Neuritis in Indian Population: An Institutional Study

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Title Visual Outcomes and Clinical Manifestations of Pediatric Optic Neuritis in Indian Population: An Institutional Study
Creator Selvakumar Ambika, DO, DNB, Krishnakumar Padmalakshmi, DO, DNB, Viswanathan Venkatraman, MD, Olma V. Noronha, DNB
Affiliation Departments of Neuro Ophthalmology (SA and PKL) and Radiology (OVN), Sankara Nethralaya, A Unit of Medical Research Foundation, Chennai, India; and Department of Neurology (VV), Kanchi Kamakoti Child Trust Hospital, Chennai, India
Abstract Background: Optic neuritis in children is an uncommon disorder which usually occurs after a viral illness or vaccination and, less frequently, occurs as a manifestation of a demyelinating disorder. Pediatric optic neuritis usually is bilateral and presents with optic disc edema, recovers rapidly with steroid therapy, and generally has low conversion rate to multiple sclerosis or neuromyelitis optica spectrum disorder. We report the clinical features and treatment outcomes of pediatric optic neuritis in Indian population, for which little data are available. Methods: We reviewed the medical case records of patients with optic neuritis who were younger than 18 years, from 1999 to 2016. All patients were assessed and managed in the Neuro-Ophthalmology Department of Sankara Nethralaya, a unit of Medical Research Foundation and Pediatric Neurology Department of Kanchi Kamakoti-Childs Trust Hospital, Chennai, India. Results: One hundred seventeen eyes of 78 children with mean age of 11.84 (+/-4.58) years were identified. Forty-two (53.8%) were females and 36 (46.2%) were males. Thirty-nine patients (50%) had bilateral involvement and a similar number had unilateral involvement. Fifty-nine eyes (50.4%) had optic disc edema, 20 eyes (17.1%) had disc pallor, and 38 eyes (32.4%) had normal discs. Of 63 patients who had neuroimaging, 36 had MRI, and 27 underwent computed tomography. Eighty-four eyes (of 59 patients) received steroid therapy according to the protocol of the Optic Neuritis Treatment Trial (ONTT). Thirty-three eyes that were treated with other steroid protocols were excluded from the final visual outcome analyses. Sixty of the 84 eyes (72.3%) recovered visual acuity of 20/40 or better. Visual acuity improvement was statistically significant between initial and final visual acuity (logMAR) in our patients treated with the ONTT protocol (P <= 0.001). Conclusions: Our Indian pediatric population had good visual recovery after steroid treatment for optic neuritis. Profound loss of visual acuity on presentation and bilateral involvement were significantly associated with poor visual outcome.
OCR Text Show
Publisher Lippincott, Williams & Wilkins
Date 2018-12
Type Text
Source Journal of Neuro-Ophthalmology, December 2018, Volume 38, Issue 4
Language eng
Rights Management © North American Neuro-Ophthalmology Society
Publication Type Journal Article
ARK ark:/87278/s6tj3njn
Setname ehsl_novel_jno
Date Created 2020-01-08
Date Modified 2020-03-23
ID 1500788
Reference URL
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