Optic neuritis in Turkish children and adolescents: A multicenter retrospective study

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dc.contributor.authorDirek M.Ç.
dc.contributor.authorBesen Ş.
dc.contributor.authorÖncel İ.
dc.contributor.authorGünbey C.
dc.contributor.authorÖzdoğan O.
dc.contributor.authorOrgun L.T.
dc.contributor.authorSahin S.
dc.contributor.authorCansu A.
dc.contributor.authorYıldız N.
dc.contributor.authorKanmaz S.
dc.contributor.authorYılmaz S.
dc.contributor.authorTekgül H.
dc.contributor.authorTürkdoğan D.
dc.contributor.authorÜnver O.
dc.contributor.authorThomas G.Ö.
dc.contributor.authorBaşıbüyük S.
dc.contributor.authorYılmaz D.
dc.contributor.authorKurt A.N.
dc.contributor.authorGültutan P.
dc.contributor.authorÖzsoy Ö.
dc.contributor.authorYiş U.
dc.contributor.authorKurul S.H.
dc.contributor.authorGüngör S.
dc.contributor.authorÖzgör B.
dc.contributor.authorKaradağ M.
dc.contributor.authorDündar N.O.
dc.contributor.authorGençpınar P.
dc.contributor.authorBildik O.
dc.contributor.authorOrak S.A.
dc.contributor.authorKabur Ç.Ç.
dc.contributor.authorKara B.
dc.contributor.authorKaraca Ö.
dc.contributor.authorCanpolat M.
dc.contributor.authorGümüş H.
dc.contributor.authorPer H.
dc.contributor.authorYılmaz Ü.
dc.contributor.authorKaraoğlu P.
dc.contributor.authorErsoy Ö.
dc.contributor.authorTosun A.
dc.contributor.authorÖztürk S.B.
dc.contributor.authorYüksel D.
dc.contributor.authorAtasoy E.
dc.contributor.authorGücüyener K.
dc.contributor.authorYıldırım M.
dc.contributor.authorBektaş Ö.
dc.contributor.authorÇavuşoğlu D.
dc.contributor.authorYarar Ç.
dc.contributor.authorGüngör O.
dc.contributor.authorMert G.G.
dc.contributor.authorSarıgeçili E.
dc.contributor.authorEdizer S.
dc.contributor.authorÇetin İ.D.
dc.contributor.authorAydın S.
dc.contributor.authorDiler B.
dc.contributor.authorÖzdemir A.A.
dc.contributor.authorErol İ.
dc.contributor.authorOkuyaz Ç.
dc.contributor.authorAnlar B.
dc.date.accessioned2024-07-22T08:02:04Z
dc.date.available2024-07-22T08:02:04Z
dc.date.issued2024
dc.description.abstractBackground: Various etiologies may underlie optic neuritis, including autoantibody-mediated disorders described in the last decade. We re-examined demographic, clinical, laboratory features and prognostic factors in pediatric patients with autoimmune optic neuritis according to current knowledge. Methods: Cases of pediatric ON from 27 centers in Türkiye diagnosed between 2009 and 2022 were included for retrospective evaluation. Results: The study included 279 patients, 174 females and 105 males, with a female-to-male ratio of 1.65. The average age at onset was 12.8 ± 3.4 years, and mean follow-up, 2.1 years (range: 1–12.1 years). Patients <10 years old were grouped as "prepubertal" and those ≥10 years old as "others”. The diagnoses made at the end of follow-up were multiple sclerosis associated optic neuritis (n = 90, 32.3 %), single isolated optic neuritis (n = 86, 31 %), clinically isolated syndrome (n = 41, 14.7 %), myelin oligodendrocyte glycoprotein antibody associated optic neuritis (n = 22, 7.9 %), and relapsing isolated optic neuritis (n = 18, 6.5 %). Predominant diagnoses were myelin oligodendrocyte glycoprotein antibody associated optic neuritis and acute disseminated encephalomyelitis associated optic neuritis in the prepubertal group and multiple sclerosis associated optic neuritis in the older group. Recurrences were observed in 67 (24 %) patients, including 28 with multiple sclerosis associated optic neuritis, 18 with relapsing isolated optic neuritis, 11 with myelin oligodendrocyte glycoprotein antibody associated optic neuritis, 8 with aquaporin-4 antibody related optic neuritis, and 2 with chronic relapsing inflammatory optic neuropathy. Recurrences were more common among female patients. Findings supporting the diagnosis of multiple sclerosis included age of onset ≥ 10 years (OR=1.24, p = 0.027), the presence of cranial MRI lesions (OR=26.92, p<0.001), and oligoclonal bands (OR=9.7, p = 0.001). Treatment in the acute phase consisted of intravenous pulse methylprednisolone (n = 46, 16.5 %), pulse methylprednisolone with an oral taper (n = 212, 76 %), and combinations of pulse methylprednisolone, plasmapheresis, or intravenous immunoglobulin (n = 21, 7.5 %). Outcome at 12 months was satisfactory, with 247 out of 279 patients (88.5 %) demonstrating complete recovery. Thirty-two patients exhibited incomplete recovery and further combination treatments were applied. Specifically, patients with relapsing isolated optic neuritis and aquaporin-4 antibody related optic neuritis displayed a less favorable prognosis. Conclusion: Our results suggest optic neuritis is frequently bilateral in prepubertal and unilateral in peri‑ or postpubertal patients. Age of onset 10 or older, presence of oligoclonal bands, and brain MRI findings reliably predict the development of multiple sclerosis. The risk of developing multiple sclerosis increases mostly during the second and third years of follow-up. Relapsing isolated optic neuritis remains a separate group where the pathogenesis and outcome remain unclear. Investigation of predisposing and diagnostic biomarkers and long follow-up could help to define this group. © 2023 Elsevier B.V.
dc.identifier.DOI-ID10.1016/j.msard.2023.105149
dc.identifier.issn22110348
dc.identifier.urihttp://akademikarsiv.cbu.edu.tr:4000/handle/123456789/11701
dc.language.isoEnglish
dc.publisherElsevier B.V.
dc.subjectAdolescent
dc.subjectAquaporin 4
dc.subjectAquaporins
dc.subjectAutoantibodies
dc.subjectChild
dc.subjectFemale
dc.subjectHumans
dc.subjectMale
dc.subjectMethylprednisolone
dc.subjectMultiple Sclerosis
dc.subjectMyelin-Oligodendrocyte Glycoprotein
dc.subjectNeuromyelitis Optica
dc.subjectOligoclonal Bands
dc.subjectOptic Neuritis
dc.subjectRetrospective Studies
dc.subjectTurkey
dc.subjectmethylprednisolone
dc.subjectmyelin oligodendrocyte glycoprotein
dc.subjectprotein antibody
dc.subjectaquaporin
dc.subjectaquaporin 4
dc.subjectautoantibody
dc.subjectmethylprednisolone
dc.subjectmyelin oligodendrocyte glycoprotein
dc.subjectoligoclonal band
dc.subjectadolescent
dc.subjectadolescent health
dc.subjectArticle
dc.subjectchild
dc.subjectchild health
dc.subjectclinical evaluation
dc.subjectclinical feature
dc.subjectconvalescence
dc.subjectdemography
dc.subjectdisease association
dc.subjectdisease predisposition
dc.subjectdrug effect
dc.subjectdrug pulse therapy
dc.subjectfemale
dc.subjectfollow up
dc.subjecthuman
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmulticenter study (topic)
dc.subjectmultiple sclerosis
dc.subjectnuclear magnetic resonance imaging
dc.subjectonset age
dc.subjectoptic neuritis
dc.subjectprognosis
dc.subjectrecurrent disease
dc.subjectretrospective study
dc.subjectrisk assessment
dc.subjectsex ratio
dc.subjecttrend study
dc.subjectTurk (people)
dc.subjectclinical trial
dc.subjectcomplication
dc.subjectepidemiology
dc.subjectmulticenter study
dc.subjectmultiple sclerosis
dc.subjectmyelooptic neuropathy
dc.subjectoptic neuritis
dc.subjectturkey (bird)
dc.titleOptic neuritis in Turkish children and adolescents: A multicenter retrospective study
dc.typeArticle

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