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Optic neuritis: a population-based study in Olmsted County, Minnesota
M Rodriguez1, A Siva, S A Cross
1Department of Neurology, Mayo Clinic, Rochester, MN 55905.
Abstract:
We reviewed the records of all patients with optic neuritis (ON) in Olmsted County, Minnesota, identified through the comprehensive records-linkage system at the Mayo Clinic, and identified 156 ON patients from 1935 to 1991 who had onset of the disease while residing in Olmsted County (incidence cases). Poisson regression analysis revealed that age, gender, and calendar year were associated with incidence. The annual age- and sex-adjusted incidence rate was 5.1 per 100,000 person-years from 1985 to 1991. On December 1, 1991, 128 patients with a documented history of ON resided in Olmsted County (prevalence cohort). The age- and sex-adjusted prevalence rate per 100,000 was 115. The average length of follow-up for the incidence cohort was 13.2 years. Life table analysis showed that 39% of the 95 patients with isolated ON in the incidence cohort had progressed to clinically definite multiple sclerosis (MS) by 10 years of follow-up, that 49% had by 20 years, 54% by 30 years, and 60% by 40 years. There was no difference in the risk of developing MS between men and women. The presence of venous sheathing (p = 0.044) and evidence for recurrent ON (p < 0.0001) were associated with an increased likelihood of developing MS. The estimated 25-year survival rate was 88.3% +/- 5.8% for the incidence cohort with isolated ON, compared with 83.9% for the general US population of similar age and sex.
Insights
Optic neuritis (ON) incidence is associated with age, gender, and year. Isolated ON patients have a 60% risk of developing multiple sclerosis (MS) within 40 years, with venous sheathing and recurrent ON increasing this risk.
Area of Science:
- Neurology
- Ophthalmology
- Epidemiology
Background:
- Optic neuritis (ON) is an inflammatory condition affecting the optic nerve.
- Understanding the long-term outcomes and risk factors for ON is crucial for patient management and prognosis.
Purpose of the Study:
- To determine the incidence and prevalence of optic neuritis in Olmsted County, Minnesota.
- To identify factors associated with the progression of isolated ON to clinically definite multiple sclerosis (MS).
- To assess the long-term survival rates for patients with isolated ON.
Main Methods:
- Retrospective review of medical records for ON patients in Olmsted County from 1935 to 1991.
- Poisson regression analysis for incidence rates and logistic regression for risk factors.
- Life table analysis for progression to MS and survival rates.
Main Results:
- The age- and sex-adjusted incidence rate of ON was 5.1 per 100,000 person-years (1985-1991).
- The age- and sex-adjusted prevalence rate was 115 per 100,000 (1991).
- Within 40 years, 60% of isolated ON patients progressed to MS; venous sheathing and recurrent ON were significant predictors.
- The 25-year survival rate for isolated ON patients was 88.3%, comparable to the general population.
Conclusions:
- Optic neuritis incidence and prevalence rates were established for Olmsted County.
- Recurrent ON and venous sheathing are key indicators for MS development.
- Patients with isolated ON have a favorable long-term survival prognosis.