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Optic neuritis in children: clinical features and visual outcome
1Department of Ophthalmology, Baylor College of Medicine, Texas Children's Hospital, Houston 77030, USA.
Summary
Pediatric optic neuritis often leads to good visual recovery, but some children experience lasting visual impairment. Normal brain MRI scans in pediatric optic neuritis cases may indicate a better prognosis.
Area of Science:
- Ophthalmology
- Neurology
- Pediatrics
Background:
- Pediatric optic neuritis presents a spectrum of clinical features.
- Understanding these features is crucial for diagnosis and management.
- Associated systemic diseases can impact outcomes.
Purpose of the Study:
- To investigate the clinical spectrum of pediatric optic neuritis.
- To evaluate presenting features, neuroimaging, CSF findings, and associated diseases.
- To determine the visual outcome in affected children.
Main Methods:
- Retrospective analysis of pediatric optic neuritis cases from 1991-1997.
- Review of initial visual loss, visual recovery, and associated conditions.
- Analysis of magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) findings.
Main Results:
- Eighty-four percent of patients presented with severe visual loss (20/200 or less).
- Seventy-six percent of affected eyes achieved 20/40 or better visual acuity after treatment.
- Normal brain MRI was associated with better visual recovery (100% achieved 20/40 or better).
- Younger children (≤6 years) were more likely to have bilateral optic neuritis and better visual prognosis.
Conclusions:
- Pediatric optic neuritis generally has a favorable visual outcome, but 22% may have persistent visual disability.
- Normal brain MRI findings may predict a better visual prognosis in pediatric optic neuritis.
- Younger age at presentation correlates with bilateral disease and improved visual outcomes.