title: Relapsing optic neuritis: a multicentre study of 62 patients.
abstract: Optic neuritis (ON) may be the first symptom of a central nervous system demyelinating, systemic or infectious disease but few patients experience recurrent episodes and have a negative workup.
  
  
  
  This disorder, named relapsing optic neuritis (RON), is poorly described in the literature and still presents a particular challenge in diagnosis and management.
  
  
  
  We describe the clinical, laboratory, magnetic resonance imaging (MRI) and disability course of RON in a French cohort of 62 patients, based on a multicentre, retrospective, observational study.
  
  
  
  In our cohort, we identified two distinct groups of RON patients. The first is characterised by relapsing inflammatory optic neuritis (RION, 68%), which is non-progressive, whereas the second presented as a chronic relapsing inflammatory optic neuritis (CRION, 32%), which is progressive. We have noted more cases with steroid dependence in the CRION group than the RION group (42% vs 10%). The long-term visual prognosis was more severe in CRION patients and neuromyelitis optica-immunoglobulin G (NMO-IgG)-positive patients.
  
  
  
  RON is likely a separate entity corresponding to an autoimmune disease that differs from multiple sclerosis (MS), NMO and vasculitis. We provide a new classification system based on a better understanding of RON which could allow an improved management by early treatment of poor prognosis forms.
authors.affiliation: University Hospital, France Clinical Investigation Centre, INSERM 10002, France aurelienbenoilid@gmail.com.
authors.forename: Aurélien
authors.initials: A
authors.lastname: Benoilid
authors.affiliation: Neurological Hospital Pierre Wertheimer, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Tilikete
authors.affiliation: University Hospital, France Clinical Investigation Centre, INSERM 10002, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Collongues
authors.affiliation: University Hospital, France.
authors.forename: Carl
authors.initials: C
authors.lastname: Arndt
authors.affiliation: Neurological Hospital Pierre Wertheimer, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Vighetto
authors.affiliation: University Hospital Lariboisière, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Vignal
authors.affiliation: University Hospital, France Clinical Investigation Centre, INSERM 10002, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: de Seze
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D005602:France; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009902:Optic Neuritis / Q000145:classification / Q000175:diagnosis* / Q000276:immunology / Q000503:physiopathology; D011237:Predictive Value of Tests; D012008:Recurrence; D012189:Retrospective Studies; D009626:Terminology as Topic; D013997:Time Factors; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D015415:Biomarkers; D007074:Immunoglobulin G
keywords: CRION; NMO-IgG; Optic neuritis; RON; multiple sclerosis