title: Optic neuritis: prognosis for multiple sclerosis from MRI, CSF, and HLA findings.
abstract: We investigated the paraclinical profile of monosymptomatic optic neuritis (ON) and its prognosis for multiple sclerosis (MS). The correct identification of patients with very early MS carrying a high risk for conversion to clinically definite MS is important when new treatments are emerging that hopefully will prevent or at least delay future MS. We conducted a prospective single observer and population-based study of 147 consecutive patients (118 women, 80%) with acute monosymptomatic ON referred from a catchment area of 1.6 million inhabitants between January 1, 1990 and December 31, 1995. Of 116 patients examined with brain MRI, 64 (55%) had three or more high signal lesions, 11 (9%) had one to two high signal lesions, and 41 (35%) had a normal brain MRI. Among 143 patients examined, oligoclonal IgG (OB) bands in CSF only were demonstrated in 103 patients (72%). Of 146 patients analyzed, 68 (47%) carried the DR15,DQ6,Dw2 haplotype. During the study period, 53 patients (36%) developed clinically definite MS. The presence of three or more MS-like MRI lesions as well as the presence of OB were strongly associated with the development of MS (p < 0.001). Also, Dw2 phenotype was related to the development of MS (p = 0.046). MRI and CSF studies in patients with ON give clinically important information regarding the risk for future MS.
authors.affiliation: Division of Ophthalmology, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Söderström
authors.forename: J
authors.initials: J
authors.lastname: Ya-Ping
authors.forename: J
authors.initials: J
authors.lastname: Hillert
authors.forename: H
authors.initials: H
authors.lastname: Link
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D018450:Disease Progression; D005260:Female; D006680:HLA Antigens / Q000032:analysis* / Q000235:genetics; D006239:Haplotypes; D006801:Humans; D007136:Immunoglobulins / Q000134:cerebrospinal fluid*; D015993:Life Tables; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid / Q000150:complications* / Q000175:diagnosis*; D043025:Oligoclonal Bands; D009902:Optic Neuritis / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000209:etiology; D011379:Prognosis; D011446:Prospective Studies
chemical_list: D006680:HLA Antigens; D007136:Immunoglobulins; D043025:Oligoclonal Bands