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Arch Ophthalmol. 2008 Jan;126(1):12-6. doi: 10.1001/archophthalmol.2007.26.

Clinical course of optic neuritis in patients with relapsing neuromyelitis optica.

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  • 1Departamento de Neurologia, UNIRIO, Rua Mariz e Barros 775, Tijuca, 20270-004, Rio de Janeiro, RJ, Brazil. regina_alvarenga@hotmail.com

Abstract

OBJECTIVE:

To describe the clinical characteristics, course, and prognosis of optic neuritis in recurrent neuromyelitis optica.

METHODS:

We analyzed 60 patients diagnosed using 1999 Mayo Clinic criteria who were seen between 1985 and 2004 at Hospital da Lagoa (Rio de Janeiro, Brazil).

RESULTS:

Optic neuritis was the initial feature in 53.3% of patients, most with unilateral disease. Recurrent optic neuritis before myelitis occurred in 18.3%. The visual impairment was severe at nadir of the visual index event in 78.3%, with a high remission rate. In the median disease duration of 8 years (range, 0.5-30 years), 380 relapses (118 optic neuritis, 223 myelitis, 39 optic neuritis and myelitis) occurred. At the last follow-up, 53.3% of patients had bilateral visual impairment and 63.3% were blind in at least 1 eye. A high mortality rate (23.3%) was due to cervical myelitis. Mortality rates were significantly higher among Afro Brazilian patients (58.3%).

CONCLUSIONS:

Optic neuritis in patients with recurrent neuromyelitis optica has a severe and acute onset, with predominantly unilateral lesions followed by improvement of clinical symptoms. In the long-term, the disease leads to severe bilateral visual impairment. Mortality rates are higher among patients of Afro Brazilian descent.

[PubMed - indexed for MEDLINE]
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