Contributions
Abstract: P379
Type: Poster
Abstract Category: Clinical aspects of MS - Neuro-ophthalmology
Introduction: Optic Neuritis (ON) is the initial presentation of multiple sclerosis (MS) in approximately 20% of patients. Although abnormal baseline brain MRI is the strongest conversion predictor, patients with normal MRI can also develop MS. In these patients predictors of conversion are still to be determined. Our objective is to estimate MS risk and identify conversion predictors in ON patients with normal baseline MRI.
Methods: Retrospective chart review of patients with idiopathic ON and normal MRI, presenting to our hospital between 2005 and 2015. Demographic, clinical, paraclinical and treatment data were collected and analyzed.
Results: 44 patients were included. 10 patients converted to MS, seven during the first 2 years and the remaining during the next 3 years. 5-year MS conversion rate was 25.8%. A statistically significant increase in MS conversion rate was associated with retrobulbar ON (p=0.024), a history of previous symptoms suggestive of demyelination (p=0.002), positive oligoclonal bands in CSF (p=0.004) and incomplete recovery (p=0.002). Age, sex, ON laterality, other neurological exam abnormalities, abnormal visual evoked potentials, corticosteroid treatment or ON recurrence were not associated with a significant increase in MS conversion rates.
Conclusion: A considerable proportion of patients with ON and normal baseline brain MRI will develop MS. The risk of conversion appears to be higher during the first 2 years, so follow up, at least during this period, is advisable. Early immunomodulatory treatment may be considered individually, especially in patients with multiple factors associated with increased MS conversion risk
Disclosure: nothing to disclose
Abstract: P379
Type: Poster
Abstract Category: Clinical aspects of MS - Neuro-ophthalmology
Introduction: Optic Neuritis (ON) is the initial presentation of multiple sclerosis (MS) in approximately 20% of patients. Although abnormal baseline brain MRI is the strongest conversion predictor, patients with normal MRI can also develop MS. In these patients predictors of conversion are still to be determined. Our objective is to estimate MS risk and identify conversion predictors in ON patients with normal baseline MRI.
Methods: Retrospective chart review of patients with idiopathic ON and normal MRI, presenting to our hospital between 2005 and 2015. Demographic, clinical, paraclinical and treatment data were collected and analyzed.
Results: 44 patients were included. 10 patients converted to MS, seven during the first 2 years and the remaining during the next 3 years. 5-year MS conversion rate was 25.8%. A statistically significant increase in MS conversion rate was associated with retrobulbar ON (p=0.024), a history of previous symptoms suggestive of demyelination (p=0.002), positive oligoclonal bands in CSF (p=0.004) and incomplete recovery (p=0.002). Age, sex, ON laterality, other neurological exam abnormalities, abnormal visual evoked potentials, corticosteroid treatment or ON recurrence were not associated with a significant increase in MS conversion rates.
Conclusion: A considerable proportion of patients with ON and normal baseline brain MRI will develop MS. The risk of conversion appears to be higher during the first 2 years, so follow up, at least during this period, is advisable. Early immunomodulatory treatment may be considered individually, especially in patients with multiple factors associated with increased MS conversion risk
Disclosure: nothing to disclose