Predicting Conversion to Multiple Sclerosis in Pediatric Optic Neuritis

Robert T. Naismith, MD reviewing Heussinger N et al. Ann Neurol 2015 Jun.

Abnormal baseline imaging and presence of oligoclonal bands were major determinants of risk for conversion.

In this retrospective study, researchers evaluated 357 children younger than 18 years who presented with isolated optic neuritis as a first demyelinating event. Data were collected from 27 hospitals. Median age at onset was 14 years, 68% were girls, and median follow-up was 4 years.

At the end of follow-up, 41% had been diagnosed with multiple sclerosis (MS). Other diagnoses included isolated optic neuritis (47%), recurrent inflammatory optic neuritis (11%), and neuromyelitis optica (1%). Risk for MS increased with higher age, abnormal brain magnetic resonance imaging (MRI) at baseline, and cerebrospinal fluid (CSF) with oligoclonal bands (OCBs). The combination of abnormal MRI and OCBs increased the hazard ratio to more than 20 times the risk for those without an abnormal MRI or OCBs. Having both MRI abnormalities and OCBs was associated with conversion in 95% of cases.

Citation(s):

Heussinger N et al. Oligoclonal bands predict multiple sclerosis in children with optic neuritis. Ann Neurol 2015 Jun; 77:1076.