This condition, also known as devic disease, is an autoimmune disorder characterized by optic neuritis and myelitis that spares the brain in early stages. Optic neuritis is an uncommon condition in the pediatric population and usually underlies a viral cause. It is also known as optic papillitis when the head of the optic nerve is involved, neuroretinitis when there is a combined involvement of optic disc and surrounding retina in the macular area and retrobulbar neuritis when the. In the past decade, the disease phenotypes for demyelinating syndromes in children have been more clearly defined. In pediatric optic neuritis usually occurs after an infectious event, with. Optic neuritis, multiple sclerosis, visual prognosis. This disease can happen to anyone at any age, but most cases occur in women who are between the ages of 20 to 40. Efns guidelines on diagnosis and management of neuromyelitis. Neurologic impairment 10 years after optic neuritis. Pediatric optic neuritis may present as a clinically isolated syndrome or in the setting of underlying neurologic disease. Optic neuritis is a condition that can happen because of a disease or without any specific known cause. Optic neuritis is a demyelinating inflammation of the optic nerve. Optic neuritis is often the initial presentation of multiple sclerosis ms. Neuritis optica trastornos oftalmicos manual msd version.
Exciting developments have occurred over the past decade in understanding of optic neuritis pathophysiology, and these developments have been translated into treatment trials. Significant clinical investigation of optic neuritis occurring in adults guides current clinical practices. Neuropatia optica isquemica disturbios oftalmologicos. In the united states, optic neuritis occurs more commonly in caucasians than in africanamericans. The treatment of optic neuritis requires first that the physician determine the etiology and comorbidities of the affected patient in order to plan a proper therapeutic plan. Retrospective analysis of all patients younger than 16 years old, with clinical criteria of optic neuritis were revised at the pediatric neurology department of the hospital universitario dr. Differences in presentation and prognosis exist for pediatric patients with optic neuritis when compared with adults including the risk of developing multiple sclerosis. The ocular symptoms of nmo include optic neuritis, vision loss and unilateral or bilateral ocular pain. Optic neuritis on occurs in approximately onefourth of children presenting with an initial demyelinating event. As established by the optic neuritis treatment trial, an abnormal baseline brain mri is a strong predictor of ms after. Eye practitioners should be also aware of neuromyelitis optica nmo. Though this disease is more common in adults, the pediatric ophthalmologist should also be aware of it, as well as its evaluation and treatment, because associations between optic neuritis and other neuroinflammatory syndromes may affect final visual and systemic outcomes. O ptic neuritis is defined as an inflammatory disease of the optic nerve.
Apr 10, 2018 o ptic neuritis is defined as an inflammatory disease of the optic nerve. Neuritis optica diagnostico y tratamiento mayo clinic. Although the visual prognosis is excellent in the majority of cases, many patients develop pathology, such as. In its typical form, optic neuritis presents as an inflammatory demyelinating disorder of the optic nerve, which can be associated with. Experiencia clinica en anos optic neuritis in children.
Our neuropaediatrics department has assessed 20,744 patients in the last 27 years, of whom 14 were diagnosed with on. The risk of evolving multiple sclerosis is probably less than in adults, but pediatric optic neuritis is more likely to be an initial manifestation of acute disseminated encephalomyelitis. Optic neuritis, its differential diagnosis and management. The aim of this paper is to present the clinical and laboratory characteristics of cases of optic neuritis in children. Abstract inflammatory optic neuritis on is the most frequent cause of acute visual loss in young adults. As established by the optic neuritis treatment trial, an abnormal baseline brain mri is a strong predictor of ms after isolated optic neuritis in adults. Acute optic neuritis is the most common optic neuropathy affecting young adults. However, the rate of conversion to ms after optic neuritis in children based upon brain mri findings is unknown. Steroids may hasten visual recovery, but they do not change visual outcome except in cases because of neuromyelitis optica. In pediatric optic neuritis usually occurs after an infectious event, with papilledema, bilateral and with good prognosis, with a low incidence of conversion to multiple sclerosis.
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