Abstract
Amaç: Optik nörit (ON), akut ve subakut görme kaybı ile başlayan, optik sinirin demiyelinizasyonu ile karakterize bir otoimmün hastalıktır. İzole, idiyopatik bir durum olarak ortaya çıkabildiği gibi Multipl Skleroz (MS) veya Nöromiyelitis Optika (NMO) gibi hastalıkların öncüsü de olabilir. Çalışmamızda çocuk hastalarda optik nörit tanılı vakaların demografik özelliklerini ve uzun dönem prognozu değerlendirmeyi amaçladık. Gereç ve Yöntem: Bu çalışmada, 2010-2017 yılları arasında çocuk nöroloji kliniğine başvuran ve akut ON tanısı alan hastalar retrospektif olarak değerlendirildi. Bulgular: ON tanısı alan 13 hasta çalışmaya dahil edildi. Bunların 6’sına (%46,15) izole ON tanısı kondu. Hastaların dokuzu kadın ve ortalama yaş 12,8±3,07 yıldı. Yedi hastada (%53,85) tek taraflı tutulum vardı. On iki hastada tam bir iyileşme sağlanırken, MS tanısı alan iki hastanın takibinde nüks gelişti. Sonuç: Görme bulanıklığı ve görme kaybı olan her çocukta ON mutlaka düşünülmelidir. Erken dönem steroid tedavisi en etkili tedavidir.
Keywords
References
- 1. Optic Neuritis Study Group. The 5-year risk of MS after optic neuritis. Experience of the optic neuritis treatment trial. Neurology 1997; 49: 1404–13.
- 2. El-Dairi MA, Ghasia F, BhattiMT: Pediatric optic neuritis. Int Ophthalmol Clin 2012; 52: 29-49.
- 3. O’Riordan JI, Thompson AJ, Kingsley DP, et al. The prognostic value of brain MRI in clinically isolated syndromes of the CNS. A 10-year followup. Brain 1998; 121: 495–503.
- 4. Banwell B, Kennedy J, Sadovnick D, et al: Incidence of acquired demyelination of the CNS in Canadian children. Neurology 2009; 72: 232-39.
- 5. Melinda Y. Chang, MD, and Stacy L. Pineles, MD. Pediatric Optic Neuritis. Pediatric Neurology 2017; 24: 122-28.
- 6. Cleary PA, Beck RW, Anderson MM, Jr, Kenny DJ, Backlund JY, Gilbert PR. Design, methods and conduct of the ONTT. Control Clin Trials. 1993; 14: 123–42.
- 7. M. Wilejto; M. Shroff, MD; J.R. Buncic, MD; J. Kennedy, MSc; C. Goia, et al: The clinical features, MRI findings, and outcome of optic neuritis in children. Neurology 2006; 67: 258-62
- 8. Wingerchuk DM, Weinshenker BG. Neuromyelitis optica: clinical predictors of a relapsing course and survival. Neurology 2003; 60: 848–53.
- 9. Lennon VA, Kryzer TJ, Pittock SJ, Verkman AS, Hinson SR. IgG marker of optic-spinal multiple sclerosis binds to the aquaporin-4 water channel. J Exp Med 2005; 202: 473–77.
- 10. Morales DS, Siatkowski RM, Howard CW, Warman R. Optic neuritis in children. J Pediatr Ophthalmol Strabismus 2000; 37: 254–59.
- 11. Freedman, M.S., Thompson, E.J., Deisenhammer, F., Giovannoni, G., Grimsley, G., Keir,G., et al. Recommended standard of cerebrospinal fluid analysis in the diagnosis of multiple sclerosis: a consensus statement. Arch Neurol 2005; 62, 865–70.
- 12. Obermeier, B., Lovato, L., Mentele, R., Brück, W., Forne, I., Imhof, A., et al. Related B cell clones that populate the CSF and CNS of patients with multiple sclerosis produce CSF immunoglobulin. J Neuroimmunol 2011; 233, 245–48.
- 13. Juryńczyk, M., Craner, M., Palace, J. Overlapping CNS inflammatory diseases: differentiating features of NMO and MS. J Neurol Neurosurg. Psychiatry 2015; 86, 20–5.
- 14. Pryce G, Baker D. Oligoclonal bands in multiple sclerosis; Functional significance and therapeutic implications. Does the specificity matter? Mult Scler Relat Disord. 2018 20; 25: 131-37.
- 15. Farina, G., Magliozzi, R., Pitteri, M., Reynolds, R., Rossi, S., Gajofatto, A., et al. Increased cortical lesion load and intrathecal inflammation is associated with oligoclonal bands in multipl esclerosis patients: a combined CSF and MRI study. J Neuroinflamm. 2017; 14, 40.
- 16. Lourenco, P.,Shirani, A., Saeedi, J., Oger, J., Schreiber, W.E., Tremlett, H. Oligoclonal bands and cerebrospinal fluid markers in multiple sclerosis: associations with disease course and progression. Mult Scler 2013; 19, 577–84.
Abstract
Objective: Optic neuritis (ON) is an autoimmune disease that starts with acute and subacute vision loss and is characterized by the demyelination of the optic nerve. It may appear as an isolated, idiopathic condition, or it may be a precursor of diseases such as Multiple Sclerosis (MS) or Neuromyelitis Optica (NMO). In the study, we aimed to evaluate ON patients and the longterm prognosis in pediatric patients. Material and Method: In this study, 13 patients who applied to the pediatric neurology clinic between years 2010-2017 and were diagnosed with acute ON were assessed retrospectively. Results: Thirteen patients diagnosed with ON were included in our study, six of whom were diagnosed with isolated ON (6/13, 46.15%). Nine of them were female. The average age of our patients was 12.8±3.07 years. Seven patients (53.85%) had unilateral involvement. A complete recovery was provided in 12 patients. There were recurrences in the follow-up of two patients, diagnosed with MS. Conclusion: ON should absolutely be considered in every child with blurred vision and vision loss. Early stage steroid treatment is the most efficient therapy.
Keywords
References
- 1. Optic Neuritis Study Group. The 5-year risk of MS after optic neuritis. Experience of the optic neuritis treatment trial. Neurology 1997; 49: 1404–13.
- 2. El-Dairi MA, Ghasia F, BhattiMT: Pediatric optic neuritis. Int Ophthalmol Clin 2012; 52: 29-49.
- 3. O’Riordan JI, Thompson AJ, Kingsley DP, et al. The prognostic value of brain MRI in clinically isolated syndromes of the CNS. A 10-year followup. Brain 1998; 121: 495–503.
- 4. Banwell B, Kennedy J, Sadovnick D, et al: Incidence of acquired demyelination of the CNS in Canadian children. Neurology 2009; 72: 232-39.
- 5. Melinda Y. Chang, MD, and Stacy L. Pineles, MD. Pediatric Optic Neuritis. Pediatric Neurology 2017; 24: 122-28.
- 6. Cleary PA, Beck RW, Anderson MM, Jr, Kenny DJ, Backlund JY, Gilbert PR. Design, methods and conduct of the ONTT. Control Clin Trials. 1993; 14: 123–42.
- 7. M. Wilejto; M. Shroff, MD; J.R. Buncic, MD; J. Kennedy, MSc; C. Goia, et al: The clinical features, MRI findings, and outcome of optic neuritis in children. Neurology 2006; 67: 258-62
- 8. Wingerchuk DM, Weinshenker BG. Neuromyelitis optica: clinical predictors of a relapsing course and survival. Neurology 2003; 60: 848–53.
- 9. Lennon VA, Kryzer TJ, Pittock SJ, Verkman AS, Hinson SR. IgG marker of optic-spinal multiple sclerosis binds to the aquaporin-4 water channel. J Exp Med 2005; 202: 473–77.
- 10. Morales DS, Siatkowski RM, Howard CW, Warman R. Optic neuritis in children. J Pediatr Ophthalmol Strabismus 2000; 37: 254–59.
- 11. Freedman, M.S., Thompson, E.J., Deisenhammer, F., Giovannoni, G., Grimsley, G., Keir,G., et al. Recommended standard of cerebrospinal fluid analysis in the diagnosis of multiple sclerosis: a consensus statement. Arch Neurol 2005; 62, 865–70.
- 12. Obermeier, B., Lovato, L., Mentele, R., Brück, W., Forne, I., Imhof, A., et al. Related B cell clones that populate the CSF and CNS of patients with multiple sclerosis produce CSF immunoglobulin. J Neuroimmunol 2011; 233, 245–48.
- 13. Juryńczyk, M., Craner, M., Palace, J. Overlapping CNS inflammatory diseases: differentiating features of NMO and MS. J Neurol Neurosurg. Psychiatry 2015; 86, 20–5.
- 14. Pryce G, Baker D. Oligoclonal bands in multiple sclerosis; Functional significance and therapeutic implications. Does the specificity matter? Mult Scler Relat Disord. 2018 20; 25: 131-37.
- 15. Farina, G., Magliozzi, R., Pitteri, M., Reynolds, R., Rossi, S., Gajofatto, A., et al. Increased cortical lesion load and intrathecal inflammation is associated with oligoclonal bands in multipl esclerosis patients: a combined CSF and MRI study. J Neuroinflamm. 2017; 14, 40.
- 16. Lourenco, P.,Shirani, A., Saeedi, J., Oger, J., Schreiber, W.E., Tremlett, H. Oligoclonal bands and cerebrospinal fluid markers in multiple sclerosis: associations with disease course and progression. Mult Scler 2013; 19, 577–84.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | RESEARCH |
| Authors | |
| Publication Date | July 31, 2021 |
| Submission Date | October 22, 2020 |
| Published in Issue | Year 2021 Volume: 84 Issue: 3 |
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