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[The development of multiple sclerosis following an isolated episode of optic neuritis. Magnetic resonance study]
1Unitat d'Esclerosi Múltiple, Hospital General Univérsitari Vall d'Hebron, Barcelona. jrio@ar.vhebron.es
Background:
An important controversy on the development of multiple sclerosis (MS) after an isolated episode of optic neuritis (ON) exists. Magnetic resonance imaging (MRI) is the method of election in order to detect demyelinated lesions in MS. The current study was designed to determine the prevalence of brain abnormalities on MRI and to asses the further development of MS after an isolated idiopathic ON in our population.
Patients And Methods:
From 1991 to 1995, 60 patients with decrease of visual acuity were studied, 35 (28 women, half age 31 +/- 10 years) completed criteria of idiopathic ON. A brain MRI was performed in all patients after the diagnosis of idiopathic ON and they subsequently were followed in the outpatient clinic from our center for a mean time of 29 +/- 16 months. 24 out of the 35 patients were treated with corticosteroids in different ways.
Results:
It has been found 43% of the patients with idiopathic ON to have brain lesions by MRI. During the follow-up 14% of the patients developed a clinically definite MS; all of them had a pathological brain MRI at the basal evaluation (p = 0.009). None of the patients that were treated with high-dose of intravenously corticosteroids developed MS.
Conclusions:
The prevalence of silent cerebral lesions in the MRI after an idiopathic ON is elevated in our population although further development of MS is lower possibly due to the short follow-up carried out. The presence of lesions in the MRI confers a high risk for developing MS after an idiopathic ON.
Insights
Brain lesions on MRI after optic neuritis (ON) indicate a high risk for developing multiple sclerosis (MS). Early MRI detection of these lesions is crucial for predicting MS development in ON patients.
Area of Science:
- Neurology
- Neuroimmunology
- Radiology
Context:
- Multiple Sclerosis (MS) development following optic neuritis (ON) is a significant clinical concern.
- Magnetic Resonance Imaging (MRI) is the gold standard for detecting demyelinating lesions indicative of MS.
- Understanding the prevalence of brain abnormalities post-ON is vital for risk stratification.
Purpose:
- To determine the prevalence of brain abnormalities on MRI in patients with isolated idiopathic ON.
- To assess the subsequent development of clinically definite MS in this patient cohort.
- To evaluate the predictive value of baseline MRI findings for MS development.
Summary:
- 43% of patients with idiopathic ON exhibited brain lesions on baseline MRI.
- 14% of patients developed clinically definite MS during follow-up, all with baseline MRI lesions (p=0.009).
- No MS development was observed in patients treated with high-dose intravenous corticosteroids.
Impact:
- Elevated prevalence of silent cerebral lesions on MRI after idiopathic ON in the studied population.
- Baseline MRI lesions significantly increase the risk of developing MS post-ON.
- Findings suggest MRI is a critical tool for identifying high-risk individuals for MS.