Recurrent isolated optic neuritis: A study on 22 patients

Area of Science:

• Neuro-ophthalmology
• Autoimmune Neurology

Background:

• Isolated relapsing optic neuropathy (RION) involves recurrent, painful optic nerve inflammation.
• It is distinct from multiple sclerosis (MS) or neuromyelitis optica (NMO) spectrum disorders.
• Attacks are typically steroid-responsive.

Purpose of the Study:

• To differentiate between chronic recurrent isolated optic neuritis (CRION) and recurrent isolated optic neuritis (RION).
• To evaluate treatment outcomes and disease progression in these conditions.

Main Methods:

• Diagnosis of RION required at least two distinct optic neuritis episodes.
• Patients were classified as CRION (steroid-dependent) or RION (steroid-independent).
• Exclusion criteria included features of demyelinating, infiltrative, or vasculitic disorders.

Main Results:

• 14 patients had CRION and 8 had RION; 28.5% of CRION cases developed NMO spectrum disorder features.
• CRION patients experienced significantly more optic neuritis attacks (3.79) than RION patients (2.25).
• Women comprised a higher proportion (2.6:1 ratio) of the study cohort.

Conclusions:

• CRION necessitates aggressive glucocorticoid and long-term immunosuppressive therapy.
• Prompt and sustained treatment is crucial for visual acuity restoration in CRION.
• Distinguishing CRION from RION is vital for appropriate management and prognosis.