PMID- 29637998 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20190102 LR - 20190102 IS - 1469-8749 (Electronic) IS - 0012-1622 (Linking) VI - 60 IP - 12 DP - 2018 Dec TI - Retinal nerve fibre layer thinning is associated with worse visual outcome after optic neuritis in children with a relapsing demyelinating syndrome. PG - 1244-1250 LID - 10.1111/dmcn.13757 [doi] AB - AIM: Optic neuritis may be monophasic or occur as part of a relapsing demyelinating syndrome (RDS), such as multiple sclerosis, aquaporin-4 antibody (AQP4-Ab) neuromyelitis optical spectrum disorder (NMOSD), or myelin oligodendrocyte glycoprotein antibody (MOG-Ab)-associated disease. The aims of this study were to test whether clinical, electrophysiological, and microstructural parameters differ in multiple-sclerosis-associated optic neuritis (MS-ON) and antibody-associated optic neuritis (Ab-ON); to identify the clinical and paraclinical characteristics of children suffering worse long-term visual outcome of RDS-optic neuritis; and to explore the relationship between RNFL thickness and clinical parameters in RDS-optic neuritis. METHOD: Forty-two children with optic neuritis were retrospectively studied: 22 with multiple sclerosis (MS-ON) and 20 with antibody-associated demyelination (Ab-ON: MOG-Ab=16 and AQP4-Ab=4). Clinical and paraclinical features were analysed. RESULTS: Complete recovery of visual acuity was reported in 25 out of 42 children; eight out of 38 (21%) suffered moderate or severe visual impairment (logarithm of the minimum angle of resolution [logMAR]>0.5) in their worse eye, including four out of 38 who were blind (logMAR>1.3) in their worse eye (two with multiple sclerosis, two with AQP4-Ab NMOSD). None of the children with MOG-Ab were blind. Recurrence of optic neuritis was more common in the Ab-ON group than the MS-ON group (15 out of 20 vs seven out of 22, p=0.007). Retinal nerve fibre layer (RNFL) thickness at baseline inversely correlated with visual acuity at final follow-up (r=-0.41, p=0.008). There was no significant relationship between the number of episodes of optic neuritis and mean RNFL (r=-0.08, p=0.628), nor any significant relationship between the number of episodes of optic neuritis and visual impairment (r=0.03, p=0.794). INTERPRETATION: In children with RDS, long-term visual impairment inversely correlated with RNFL thickness, but not with the number of relapses of optic neuritis. Optical coherence tomography may have a role in assessing children with optic neuritis to monitor disease activity and inform treatment decisions. WHAT THIS PAPER ADDS: Long-term visual impairment is reported in 40% of children with a relapsing demyelinating syndrome following optic neuritis. Relapse of optic neuritis, occurring more frequently in the non-multiple-sclerosis group. Retinal nerve fibre layer thinning is associated with worse visual outcome. Optical coherence tomography can be used alongside clinical parameters as an objective measure of neuroretinal loss. CI - (c) 2018 Mac Keith Press. FAU - Eyre, Michael AU - Eyre M AUID- ORCID: 0000-0002-6704-5727 AD - Department of Paediatric Neurology, Great Ormond Street Hospital for Children, London, UK. FAU - Hameed, Aasim AU - Hameed A AD - The Clinical and Academic Department of Ophthalmology, Department of Paediatric Ophthalmology, Great Ormond Street Hospital for Children, London, UK. FAU - Wright, Sukhvir AU - Wright S AD - Department of Paediatric Neurology, Birmingham Children's Hospital, Birmingham, UK. FAU - Brownlee, Wallace AU - Brownlee W AD - Department of Paediatric Neurology, Birmingham Children's Hospital, Birmingham, UK. FAU - Ciccarelli, Olga AU - Ciccarelli O AD - Department of Neuroinflammation, Queen Square MS Centre, UCL Institute of Neurology, London, UK. AD - National Institute for Health Research, UCL Hospitals, Biomedical Research Centre, London, UK. FAU - Bowman, Richard AU - Bowman R AD - The Clinical and Academic Department of Ophthalmology, Department of Paediatric Ophthalmology, Great Ormond Street Hospital for Children, London, UK. FAU - Lim, Ming AU - Lim M AD - Children's Neurosciences, Evelina London Children's Hospital at Guy's and St Thomas' NHS Foundation Trust, King's Health Partners Academic Health Science Centre, London, UK. AD - Faculty of Life Sciences and Medicine, Kings College London, London, UK. FAU - Wassmer, Evangeline AU - Wassmer E AD - Department of Paediatric Neurology, Birmingham Children's Hospital, Birmingham, UK. FAU - Thompson, Dorothy AU - Thompson D AD - The Clinical and Academic Department of Ophthalmology, Department of Paediatric Ophthalmology, Great Ormond Street Hospital for Children, London, UK. FAU - Hemingway, Cheryl AU - Hemingway C AD - Department of Paediatric Neurology, Great Ormond Street Hospital for Children, London, UK. FAU - Hacohen, Yael AU - Hacohen Y AUID- ORCID: 0000-0001-8490-9657 AD - Department of Paediatric Neurology, Great Ormond Street Hospital for Children, London, UK. AD - Department of Neuroinflammation, Queen Square MS Centre, UCL Institute of Neurology, London, UK. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20180411 PL - England TA - Dev Med Child Neurol JT - Developmental medicine and child neurology JID - 0006761 CIN - Dev Med Child Neurol. 2018 Dec;60(12):1195-1196. PMID: 29691841 EDAT- 2018/04/12 06:00 MHDA- 2018/04/12 06:01 CRDT- 2018/04/12 06:00 PHST- 2018/02/16 00:00 [accepted] PHST- 2018/04/12 06:00 [pubmed] PHST- 2018/04/12 06:01 [medline] PHST- 2018/04/12 06:00 [entrez] AID - 10.1111/dmcn.13757 [doi] PST - ppublish SO - Dev Med Child Neurol. 2018 Dec;60(12):1244-1250. doi: 10.1111/dmcn.13757. Epub 2018 Apr 11.