Risk Factors of the Optic Neuritis Study Group for Multiple Sclerosis Following an Episode of Optic Neuritis

Description

The Optic Neuritis Study Group (ONSG) identified risk factors for multiple sclerosis (MS) occurring within 15 years of an episode of optic neuritis. These can help identify patients who may benefit from early treatment. The authors are from multiple institutions around the United States.

The main risk factor was the presence of MRI abnormalities in the brain at the time of optic neuritis. 25% of patients with no lesions up to almost 80% with >= 3 lesions on MRI scan of the brain developed MS within 15 years.

Number MRI Lesions	Hazard Ratio for MS within 15 Years
0	1
1 or 2	2.7 - 2.8
>= 3	4.5

If no MRI lesions were present then risk factors for developing MS were:

(1) female gender

(2) viral syndrome preceding the optic neuritis

(3) normal appearing optic disc (i.e., absence of edema/swelling of the optic disc)

(4) typical clinical features for optic neuritis (i.e., absence of atypical features)

where:

• The absence of edema of the optic disc is indicative of retrobulbar neuritis with sparing of the anterior portion of the nerve.

Features	Typical ON	Atypical ON
light perception	present	absent
periocular pain	present	absent
optic disc swelling	absent	present
periampullary hemorrhages	absent	present
retinal exudates	absent	present

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Description

Specialty

ICD-10