Predicting the Outcome of Optic Neuritis Evaluation of risk factors after 30 years of follow-up.

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Fältnamn	Indikatorer	Metadata
000		04496naa a2200409 4500
001		oai:lup.lub.lu.se:62938e81-8649-4745-8473-9e181bfbdff7
003		SwePub
008		160401s2005 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
024	7	a https://lup.lub.lu.se/record/1348312 URI
024	7	a https://doi.org/10.1007/s00415-005-0655-92 DOI
040		a (SwePub)lu
041		a engb eng
042		9 SwePub
072	7	a art2 swepub-publicationtype
072	7	a ref2 swepub-contenttype
100	1	a Nilsson, P4 aut
245	1 0	a Predicting the Outcome of Optic Neuritis Evaluation of risk factors after 30 years of follow-up.
264		c 2005-03-22
264	1	b Springer Science and Business Media LLC,c 2005
520		a Background Multiple sclerosis ( MS) is a common disease with considerable risk for disability. Optic neuritis ( ON) is a common first symptom of MS but it can also remain an isolated episode. Therefore, predicting the outcome of ON has gained in importance, particularly in light of current discussions of early disease modifying treatments in individuals at risk of developing MS. We reported previously on our cohort of 86 patients with acute monosymptomatic unilateral ON of whom 33 had progressed to MS after up to 18 years. Three patients had died. The present study extends the observation period to 31 years. Methods Patients were followed for up to 31 years or until a diagnosis of MS was made. Cerebrospinal fluid (CSF) was examined at onset. HLA class I and II antigens were determined. Magnetic Resonance Imaging (MRI) was performed during follow up. Findings Only one of 50 patients at risk developed clinical manifestations of MS during the extended follow up period. The estimated 15-year-risk of MS was 40% ( confidence interval [CI] 31% - 52%). Most cases, 20 of 34 or 60%, occurred within three years. Among factors present at onset, CSF with mononuclear pleocytosis and/or oligoclonal Ig increased the risk for subsequent MS significantly, 49% (CI 38% - 65%) compared with 23% ( CI 12% - 44%) for those with normal CSF, p= 0.02. Younger patients and those with winter onset also had greater risk. Recurrence of ON similarly elevated the risk significantly, p< 0.001. After 19 - 31 years MRI lesions suggestive of demyelinating disease were detected in 20 of 30 individuals although no clinical manifestations of MS had occurred. Conclusion The risk of MS in this large population-based prospective ON patient series was 40% and significantly higher in those with inflammatory CSF abnormalities at onset. Clinically silent MRI lesions suggestive of MS were detected in a majority of those with "ON-only". This finding should be taken into account when discussing prognosis and early intervention in patients with clinically isolated ON.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Neurologi0 (SwePub)302072 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Neurology0 (SwePub)302072 hsv//eng
653		a MRI
653		a optic neuritis
653		a multiple sclerosis
653		a prognosis
653		a cerebrospinal fluid
700	1	a Larsson, Elna-Marieu Lund University,Lunds universitet,Diagnostisk radiologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Diagnostic Radiology, (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine4 aut0 (Swepub:lu)drad-eml
700	1	a Maly-Sundgren, P4 aut
700	1	a Perfekt, Rolandu Lund University,Lunds universitet,Medicinsk onkologi,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Medical oncology,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine4 aut0 (Swepub:lu)endo-rpe
700	1	a Sandberg Wollheim, Magnhildu Lund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine4 aut0 (Swepub:lu)neur-msw
710	2	a Diagnostisk radiologi, Lundb Sektion V4 org
773	0	t Journal of Neurologyd : Springer Science and Business Media LLCg 252:4, s. 396-402q 252:4<396-402x 1432-1459x 0340-5354
856	4	u http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15778816&dopt=Abstracty FULLTEXT
856	4	u http://dx.doi.org/10.1007/s00415-005-0655-9y FULLTEXT
856	4 8	u https://lup.lub.lu.se/record/134831
856	4 8	u https://doi.org/10.1007/s00415-005-0655-9

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Av författaren/redakt...: Nilsson, P; Larsson, Elna-Ma ...; Maly-Sundgren, P; Perfekt, Roland; Sandberg Wollhei ...

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