Recurrent Optic Neuritis as the Initial Symptom in Demyelinating Diseases.

Area of Science:

• Neuroimmunology
• Ophthalmology
• Neurology

Background:

• Recurrent optic neuritis (ON) presents diagnostic challenges.
• Differentiating between multiple sclerosis (MS), neuromyelitis optica spectrum disorders (NMOSD), and chronic relapsing inflammatory optic neuropathy (CRION) is crucial.

Purpose of the Study:

• To compare patients with recurrent ON as their initial symptom.
• To identify predictive factors for final diagnoses of MS, NMOSD, or CRION.

Main Methods:

• Retrospective analysis of medical records from 2004-2016.
• Classification of patients based on final diagnosis: MS, NMOSD, or CRION.
• Comparison of clinical characteristics to find predictive factors.

Main Results:

• 33 patients included: 6 MS, 14 NMOSD, 13 CRION.
• Higher initial Visual Functional System Score (VFSS) in NMOSD and CRION compared to MS.
• Anti-aquaporin-4 antibodies detected in 42.8% of tested patients; 77.8% of seropositive NMOSD patients had transverse myelitis.
• Lower VFSS at last appointment predicted MS.

Conclusions:

• Lower VFSS at the last medical appointment is predictive of MS.
• NMOSD and CRION share clinical similarities.
• NMOSD patients often exhibit poorer visual acuity.