Bilateral optic neuritis. A long-term follow-up

Area of Science:

• Ophthalmology
• Neurology
• Clinical Medicine

Background:

• Bilateral optic neuritis is an inflammatory condition affecting the optic nerves.
• Previous studies by Hierons and Lyle (1959) and Meadows (1969) reported cases of bilateral optic neuritis.
• The long-term prognosis and risk of developing multiple sclerosis were not fully established.

Purpose of the Study:

• To determine the long-term fate of adults and children diagnosed with bilateral optic neuritis.
• To assess the visual prognosis and the incidence of multiple sclerosis in these patient groups.
• To investigate potential differences in outcomes based on the onset of optic neuritis (simultaneous vs. sequential).

Main Methods:

• Retrospective follow-up study of patients initially reported in 1959 and 1969.
• Information gathered from various sources for long-term follow-up.
• Analysis of visual outcomes and development of clinically definite multiple sclerosis.

Main Results:

• Follow-up data obtained for 31 of 34 adults (up to 37 years) and 17 of 19 children (up to 32 years).
• Visual prognosis was variable in adults but excellent in children.
• None of the children developed multiple sclerosis; 2 of 11 adults with simultaneous onset and 8 of 20 with sequential onset developed multiple sclerosis.

Conclusions:

• The risk of developing multiple sclerosis after simultaneous bilateral optic neuritis in childhood is low.
• The risk appears higher in adults, though many remain free of disseminated disease even after decades.
• Bilateral optic neuritis is a diverse condition with varied etiology and prognosis.