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MULTIPLE SCLEROSIS RISK AFTER OPTIC NEURITIS
Check this out - results from follow up study/trial:
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Multiple sclerosis risk after optic neuritis: final optic neuritis treatment trial follow-up
Optic Neuritis Study Group.
Collaborators (28)
Brodsky M, Nazarian S, Orengo-Nania S, Hutton GJ, Buckley EG, Massey EW, Bhatti MT, Greer M, Goodwin J, Wall M, Savino PJ, Leist T, Miller NR, Irani D, Trobe JD, Cornblath W, Kaufman DI, Eggenberger E, Kupersmith MJ, Shults WT, McAllister L, Hamilton S, Beck RW, Dontchev M, Gal RL, Kollman C, Keltner JL, Smith CH.
OBJECTIVE: To assess the risk of developing multiple sclerosis (MS) after optic neuritis and the factors predictive of high and low risk. DESIGN: Subjects in the Optic Neuritis Treatment Trial, who were enrolled between July 1, 1988, and June 30, 1991, were followed up prospectively for 15 years, with the final examination in 2006. SETTING: Neurologic and ophthalmologic examinations at 13 clinical sites. PARTICIPANTS: Three hundred eighty-nine subjects with acute optic neuritis. MAIN OUTCOME MEASURES: Development of MS and neurologic disability assessment. RESULTS: The cumulative probability of developing MS by 15 years after onset of optic neuritis was 50% (95% confidence interval, 44%-56%) and strongly related to presence of lesions on a baseline non-contrast-enhanced magnetic resonance imaging (MRI) of the brain. Twenty-five percent of patients with no lesions on baseline brain MRI developed MS during follow-up compared with 72% of patients with 1 or more lesions. After 10 years, the risk of developing MS was very low for patients without baseline lesions but remained substantial for those with lesions. Among patients without lesions on MRI, baseline factors associated with a substantially lower risk for MS included male sex, optic disc swelling, and certain atypical features of optic neuritis. CONCLUSIONS: The presence of brain MRI abnormalities at the time of an optic neuritis attack is a strong predictor of the 15-year risk of MS. In the absence of MRI-detected lesions, male sex, optic disc swelling, and atypical clinical features of optic neuritis are associated with a low likelihood of developing MS. This natural history information is important when considering prophylactic treatment for MS at the time of a first acute onset of optic neuritis.
I will post the link to our favorites links HP!
-Shell
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Multiple sclerosis risk after optic neuritis: final optic neuritis treatment trial follow-up
Optic Neuritis Study Group.
Collaborators (28)
Brodsky M, Nazarian S, Orengo-Nania S, Hutton GJ, Buckley EG, Massey EW, Bhatti MT, Greer M, Goodwin J, Wall M, Savino PJ, Leist T, Miller NR, Irani D, Trobe JD, Cornblath W, Kaufman DI, Eggenberger E, Kupersmith MJ, Shults WT, McAllister L, Hamilton S, Beck RW, Dontchev M, Gal RL, Kollman C, Keltner JL, Smith CH.
OBJECTIVE: To assess the risk of developing multiple sclerosis (MS) after optic neuritis and the factors predictive of high and low risk. DESIGN: Subjects in the Optic Neuritis Treatment Trial, who were enrolled between July 1, 1988, and June 30, 1991, were followed up prospectively for 15 years, with the final examination in 2006. SETTING: Neurologic and ophthalmologic examinations at 13 clinical sites. PARTICIPANTS: Three hundred eighty-nine subjects with acute optic neuritis. MAIN OUTCOME MEASURES: Development of MS and neurologic disability assessment. RESULTS: The cumulative probability of developing MS by 15 years after onset of optic neuritis was 50% (95% confidence interval, 44%-56%) and strongly related to presence of lesions on a baseline non-contrast-enhanced magnetic resonance imaging (MRI) of the brain. Twenty-five percent of patients with no lesions on baseline brain MRI developed MS during follow-up compared with 72% of patients with 1 or more lesions. After 10 years, the risk of developing MS was very low for patients without baseline lesions but remained substantial for those with lesions. Among patients without lesions on MRI, baseline factors associated with a substantially lower risk for MS included male sex, optic disc swelling, and certain atypical features of optic neuritis. CONCLUSIONS: The presence of brain MRI abnormalities at the time of an optic neuritis attack is a strong predictor of the 15-year risk of MS. In the absence of MRI-detected lesions, male sex, optic disc swelling, and atypical clinical features of optic neuritis are associated with a low likelihood of developing MS. This natural history information is important when considering prophylactic treatment for MS at the time of a first acute onset of optic neuritis.
I will post the link to our favorites links HP!
-Shell
My first ON started May 2007. I started out with a lot of pressure and pain in my eye. I thought maybe I had used mascara that had gone bad or something. I had no idea what was wrong.
I had stabbing knife pain shooting through my eye. I've had pink eye so I knew that was not it. Then my eye started to get blurry even with my glasses on. So I called my eye doctor.
His first dx was a blister on my retina. He could not see it but didn't feel it was ON because he did not see a swollen optic nerve. He wanted me to wait a month to see what happened.
I got on line and started looking up eye problems and my symptoms sounded like ON rather than this blister thing. I called my eye doctor back to let him know I was getting worse. I had to wear sunglasses in the house, at night!
I could not tolerate any light. I could not think, my vision was a mess, I was so weak I couldn't even cut through a pizza. My right leg was weird. It felt as if it was not connected. It was not numb but not right.
So the eye doctor got me into a eye doctor who is a specialist. He sent me for an MRI. MRI confirmed ON, an active lesion, and an old lesion. But neither were in the "right" MS spot.
I went to a Neurologist who saw the ON and the lesions but because they were not in the "right" spot she didn't do anything about my ON. So I decided to go get a second opinion. Second opinion was no better. I went back to the eye doctor and he said my vision field test had improved so, ok, fine. I decided to forget it and go on.
Then January of this year I started the same symptoms in the same eye. Went back to the specialist and back into the MRI. I had a second bout of ON. My vision field test this time was worse than with the first bout of ON.
So I finally got an appointment with the MS clinic and was diagnosed with MS at the first appointment. I have never had any treatment for ON so far.
Like way too many here I was patted on the head and sent home or passed off on someone else. I would have gone to the MS clinic with my first attack but my insurance didn't cover that clinic. After the first of the year our insurance changed and I was able to go.
My PCP felt it was MS from the start and he is the one who wanted me to get to the MS clinic.
Sorry this is so long but that is my ON story. :)
LA
I had stabbing knife pain shooting through my eye. I've had pink eye so I knew that was not it. Then my eye started to get blurry even with my glasses on. So I called my eye doctor.
His first dx was a blister on my retina. He could not see it but didn't feel it was ON because he did not see a swollen optic nerve. He wanted me to wait a month to see what happened.
I got on line and started looking up eye problems and my symptoms sounded like ON rather than this blister thing. I called my eye doctor back to let him know I was getting worse. I had to wear sunglasses in the house, at night!
I could not tolerate any light. I could not think, my vision was a mess, I was so weak I couldn't even cut through a pizza. My right leg was weird. It felt as if it was not connected. It was not numb but not right.
So the eye doctor got me into a eye doctor who is a specialist. He sent me for an MRI. MRI confirmed ON, an active lesion, and an old lesion. But neither were in the "right" MS spot.
I went to a Neurologist who saw the ON and the lesions but because they were not in the "right" spot she didn't do anything about my ON. So I decided to go get a second opinion. Second opinion was no better. I went back to the eye doctor and he said my vision field test had improved so, ok, fine. I decided to forget it and go on.
Then January of this year I started the same symptoms in the same eye. Went back to the specialist and back into the MRI. I had a second bout of ON. My vision field test this time was worse than with the first bout of ON.
So I finally got an appointment with the MS clinic and was diagnosed with MS at the first appointment. I have never had any treatment for ON so far.
Like way too many here I was patted on the head and sent home or passed off on someone else. I would have gone to the MS clinic with my first attack but my insurance didn't cover that clinic. After the first of the year our insurance changed and I was able to go.
My PCP felt it was MS from the start and he is the one who wanted me to get to the MS clinic.
Sorry this is so long but that is my ON story. :)
LA
I think I've had ON, too, for a very long time. Some of things you've described are very familiar. I get the mascara in the eye feeling all the time (even when I'm not wearing any) and the dull ache has not disappeared, yet.
There was a time, a few years ago, when I thought my contact lenses hurt my eyes, because I had some intense pain in both of my eyes and couldn't even come out of a dark closet. I was driven directly to the urgent care, with a towel covering my eyes and I was diagnosed with eye infection and given drops and an ointment. I couldn't see for the entire summer--I thought that it was the stuff that was prescribed for me for my eyes. The pain was horrid and it took a few weeks to "heal". So, I'm wondering if this was actually my first bout with ON.
There was a time, a few years ago, when I thought my contact lenses hurt my eyes, because I had some intense pain in both of my eyes and couldn't even come out of a dark closet. I was driven directly to the urgent care, with a towel covering my eyes and I was diagnosed with eye infection and given drops and an ointment. I couldn't see for the entire summer--I thought that it was the stuff that was prescribed for me for my eyes. The pain was horrid and it took a few weeks to "heal". So, I'm wondering if this was actually my first bout with ON.
Have you had an MRI? That is what helped get mine dx'd last year. This second time with ON I had optic palar but still had another MRI.
LA
LA
Maybe the MRI I just had a few weeks ago will show if they are old or new lesions on the optic nerve. I haven't heard about the results yet. The MRI before last didn't show anything--but that area of brain was not focused on.
What a great bump
Very informative, can someone please tell the world about ON - when I had it so very badly in 1989 I was not even referred to a neurologist let alone let near to an MRI.
Do I sound bitter - well that's because I am!
Bless all you wonderful folks for the info you give here
Pat
x
Very informative, can someone please tell the world about ON - when I had it so very badly in 1989 I was not even referred to a neurologist let alone let near to an MRI.
Do I sound bitter - well that's because I am!
Bless all you wonderful folks for the info you give here
Pat
x
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