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Six-Month Visual Outcomes in Pediatric Optic Neuritis: A Multicenter Study From South Korea
Hye Jun Joo1, Jae Ryong Song, Byung Chan Lim
1Department of Ophthalmology (HJJ, JRS, JHJ, S-JK), Seoul National University Hospital, Seoul, Republic of Korea; Department of Pediatrics (BCL), Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Ophthalmology (WJK), Yeungnam University College of Medicine, Daegu, Korea; Department of Ophthalmology (MYC), Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea; Department of Ophthalmology (H-JL), Jeonbuk National University College of Medicine and Hospital, Jeonju, Republic of Korea; Department of Ophthalmology (SAC), Ajou University School of Medicine, Suwon, South Korea; Department of Ophthalmology (DGC), Kangnam Sacred Heart Hospital, College of Medicine Hallym University, Seoul, Korea; Department of Ophthalmology (HYK), National Health Insurance Service Ilsan Hospital, Gyeonggi-do, South Korea; Department of Ophthalmology (Y-WS), Korea University College of Medicine, Seoul, South Korea; Department of Ophthalmology (HK), Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea; Department of Ophthalmology (JYL), Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Gyeonggi-do, South Korea; Department of Ophthalmology (BYC), School of Medicine, Kyungpook National University, Daegu, Korea; Department of Ophthalmology (USK), Chung-Ang University, Seoul, Korea; Department of Ophthalmology (HH), Chonnam National University Medical School and Hospital, Donggu Gwangju, Korea; Department of Ophthalmology (HRY), College of Medicine, Eunpyeong St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea; and Department of Ophthalmology (EHH), Hanyang University College of Medicine, Hanyang University Guri Hospital, Gyeonggi-do, South Korea.
Pediatric optic neuritis often causes severe vision loss but typically shows good recovery. Myelin oligodendrocyte glycoprotein antibody-associated disease is the most frequent cause in children, guiding new treatment strategies.
Area of Science:
- Ophthalmology
- Neurology
- Pediatrics
Background:
- Pediatric optic neuritis knowledge is limited by case reports and retrospective studies.
- Ethnic variations and antibody-based diagnostics are crucial for treatment.
- Further research is needed to understand pediatric optic neuritis etiology and clinical course.
Purpose of the Study:
- To investigate the causes and clinical findings of pediatric optic neuritis.
- To improve understanding of pediatric optic neuritis in the context of antibody-based diagnostics.
- To provide baseline data for developing targeted treatment strategies.
Main Methods:
- Prospective multicenter cohort study at 31 centers.
- Included patients under 18 with first-episode optic neuritis.
- Comprehensive neuro-ophthalmic exams, antibody testing (AQP4-IgG, MOG-IgG), and MRI performed.
- Best-corrected visual acuity (BCVA) at 6 months was the primary outcome.
Main Results:
- 44 pediatric patients enrolled; mean age 10.7 years.
- Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) was the most common diagnosis (68.2%).
- Mean BCVA improved from 0.99 logMAR at enrollment to 0.24 logMAR at 6 months; 50% improved visual category.
- No significant predictors for poor visual acuity were identified.
Conclusions:
- Pediatric optic neuritis presents with significant visual impairment but demonstrates good recovery potential.
- MOGAD is the predominant etiology in pediatric optic neuritis.
- Findings highlight unique pediatric characteristics and inform tailored treatment approaches.
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