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Optic neuritis in adults and children.
Jeffrey A Boomer1, R Michael Siatkowski
1Dean A. McGee Eye Institute, Department of Ophthalmology, University of Oklahoma School of Medicine, Oklahoma City, OK 73104, USA.
Seminars in Ophthalmology
|October 30, 2004
Summary
Optic neuritis presents differently in children and adults. Early diagnosis and management by ophthalmologists are crucial for both, especially with new therapies for multiple sclerosis (MS).
Area of Science:
- Ophthalmology
- Neurology
Background:
- Optic neuritis is a common condition encountered by ophthalmologists.
- Significant differences exist in its presentation and management between pediatric and adult populations.
- Established trials like ONTT and CHAMPS provide adult data on prognosis and multiple sclerosis (MS) risk.
Purpose of the Study:
- To highlight the distinct clinical behavior of optic neuritis in children versus adults.
- To emphasize the ophthalmologist's critical role in diagnosing and managing optic neuritis.
- To underscore the importance of early intervention in light of advancements in immunomodulatory therapies for MS.
Main Methods:
- Review of existing literature and clinical trial data (ONTT, CHAMPS).
- Differential diagnosis considerations for pediatric optic neuritis.
- Emphasis on the ophthalmologist's diagnostic and management responsibilities.
Main Results:
- Optic neuritis prognosis and MS risk are well-defined in adults.
- Pediatric optic neuritis is less common but requires consideration for subacute visual loss, particularly with bilateral involvement.
- Secondary causes of optic neuritis are more prevalent in children, necessitating thorough investigation.
Conclusions:
- Ophthalmologists are central to the diagnosis, treatment, and management of optic neuritis in all age groups.
- Early and accurate diagnosis is paramount for optimal patient outcomes, especially concerning MS.
- The advent of immunomodulatory therapies increases the urgency for timely ophthalmological intervention.