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Pediatric Optic Neuritis: What Is New
Mark Borchert1, Grant T Liu, Stacy Pineles
1The Vision Center (MB), Children's Hospital Los Angeles, Los Angeles, California; Departments of Ophthalmology and Neurology (MB), Keck School of Medicine, University of Southern California, Los Angeles, California; Neuro-ophthalmology Service (GTL), Division of Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Departments of Neurology and Ophthalmology (GTL), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Ophthalmology (SP), Stein Eye Institute, University of California, Los Angeles, California; Division of Neurology (ATW), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and Departments of Neurology and Pediatrics (ATW), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Insights
Pediatric optic neuritis diagnosis and treatment are complex, often differing from adult forms. Further research is needed to clarify its relationship with neuroinflammatory diseases and optimize patient outcomes.
Area of Science:
- Neurology
- Ophthalmology
- Pediatrics
Background:
- Optic neuritis presents diagnostic challenges, blurring lines between childhood and adult-onset conditions.
- Understanding pediatric optic neuritis is crucial for diagnosing and managing neuroinflammatory diseases in children.
Purpose of the Study:
- To review the current knowledge of pediatric optic neuritis.
- To explore its relationship with neuroinflammatory disease consensus definitions.
- To examine diagnostic and treatment strategies and the need for prospective studies.
Main Methods:
- Literature review and synthesis of existing research on pediatric optic neuritis.
- Analysis of diagnostic criteria and treatment efficacy, including steroid use.
- Discussion of the potential for prospective studies in understanding the condition.
Main Results:
- Pediatric optic neuritis risk for multiple sclerosis is lower than in adults; it more commonly indicates acute disseminated encephalomyelitis.
- Steroids may speed visual recovery but do not alter long-term outcomes, except in neuromyelitis optica cases.
- The influence of puberty on presentation and risk factors remains unclear.
Conclusions:
- Pediatric optic neuritis requires further investigation through systematic prospective studies.
- Clarifying diagnostic and management issues is essential for improving pediatric neuroinflammatory disease care.
- The role of puberty in optic neuritis requires dedicated research.
Abstract:
Few diseases blur the margins between their childhood and adult-onset varieties as much as optic neuritis. This report will review our state of knowledge of pediatric optic neuritis, as well as its relationship to the latest consensus definitions of neuroinflammatory disease. Current diagnostic and treatment options will be explored, as well as our potential to uncover an understanding of pediatric optic neuritis through systematic prospective studies. The risk of evolving multiple sclerosis is probably less than in adults, but pediatric optic neuritis is more likely to be an initial manifestation of acute disseminated encephalomyelitis. Steroids may hasten visual recovery, but they do not change visual outcome except in cases because of neuromyelitis optica. The role of puberty in modifying the presentation and risk associations is unknown. Prospective studies are required to resolve these diagnostic and management issues.
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