[Acute optic neuritis in children: clinical features and treatment. A study of 28 eyes in 20 children].
OBJECTIVE
Analyzing a personal series of children with acute optic neuritis (AON), we studied


METHODS
A retrospective study of 28 eyes in 20 patients (mean age: 10;7 years), examined between 1982 and 1997, with a follow-up ranging from 6 months to 15 years (mean: 5;5 years). We recorded etiologic factors, clinical features (ocular and extra ocular), biological results, and neuroimaging findings.


RESULTS
Initial involvement was uni- or bilateral with poor visual acuity (under 20/200 in 22 eyes of 28). Intracerebral inflammation was present in 9 of 13 cases where MRI was performed. We found a cause in only 7 cases (5 viral diseases and 2 recent vaccinations against hepatitis B). Visual recovery was good (over 20/25 in 20 eyes of 28) whatever the treatment, but AON recurred in 5 children. Four children later developed multiple sclerosis.


CONCLUSIONS
The cause of AON is rarely found. After eliminating an infection, we retained viral disease, complication of a recent vaccination against hepatitis B, and neurological diseases. MRI was the imaging study of choice. Development of multiple sclerosis occurred in 4 cases of 20, the same frequency as in the literature. The risk of later development of multiple sclerosis was 20%. Progression of AON was often excellent. Nevertheless, corticotherapy was added, in form of intravenous boluses followed by decreasing oral therapy for one month.
Roussat
B
B
Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris.
Gohier
P
P
Doummar
D
D
Iba-Zizen
M T
MT
Barbat
V
V
Jarry
D
D
Cabanis
E A
EA
Hamard
H
H
Nordmann
J P
JP
D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D006801:Humans; D008279:Magnetic Resonance Imaging; D009103:Multiple Sclerosis / Q000503:physiopathology; D009902:Optic Neuritis / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D014792:Visual Acuity