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Show 270 Clinical Characteristics and Treatment Effects of Chronic Immunotherapy in Idiopathic Recurrent Papillitis and Idiopathic Recurrent Neuroretinitis: A Multi-center Retrospective Analysis Minjun Hur 1, Natthapon Rattanathamsakul 2, Samuel Jang 1, Deena Tajfirouz 2, Kevin Chodnicki 2, Anastasia Zekeridou 1, Collin McClelland 3, John Chen 2 1 Mayo Clinic Rochester, 2 Mayo Clinic, 3 University of Minnesota Introduction: Idiopathic recurrent neuroretinitis is described by recurrent attacks of optic disc edema and macular star. Idiopathic recurrent papillitis presents with recurrent attacks of disc edema without macular star. We sought to better characterize the clinical features of idiopathic recurrent papillitis in comparison to idiopathic recurrent neuroretinitis, including the treatment effects of chronic immunotherapy. Methods: This is a multi-center retrospective review of 30 patients with either idiopathic recurrent papillitis or idiopathic recurrent neuroretinitis (all without retrobulbar enhancement of the optic nerve during the acute attack). Gender, race, age at first attack, number of attacks, and number of attacks on chronic immunotherapy were recorded. For patients who started immunotherapy, annualized relapse rates (ARR) on and off chronic immunotherapy were calculated. Results: Among 30 patients, 18 (60.0%) patients had neuroretinitis attacks at least once, and 12 (40.0%) patients had only papillitis attacks. Among patients with neuroretinitis, 10 (55.6%) patients also had attacks of papillitis without neuroretinitis. The median number of attacks for all patients was 4 (IQR 2, 3-5). Twelve (66.6%) patients in the neuroretinitis group were female compared to four patients (33.3%) in the papillitis group (p=0.07). The average age at first attack was 37.3 years for the neuroretinitis group and 37.7 years for the papillitis group (p=0.95). Nineteen (63.3%) patients were initiated on chronic immunotherapy, of which nine (47.4%) relapsed with an average ARR of 0.40 attacks/year. This was lower than the average ARR off chronic therapy (0.84 attacks/year), but not statistically significantly different (p=0.08). Conclusions: We describe the clinical features of idiopathic recurrent papillitis in comparison to idiopathic recurrent neuroretinitis, which may be the same disease process with some patients having both papillitis and neuroretinitis. There was a trend toward chronic immunotherapy reducing the number of relapses in idiopathic recurrent papillitis/neuroretinitis. References: None provided. Keywords: Optic neuropathy, Neuro-ophth & systemic disease ( eg. MS, MG, thyroid) Financial Disclosures: The authors had no disclosures. Grant Support: None. Contact Information: John Chen, chen.john@mayo.edu 430 | North American Neuro-Ophthalmology Society |
