title: Parainfectious optic neuritis: manifestations in children vs adults.
abstract: BACKGROUND
  Parainfectious optic neuritis may appear at any age. The aim of our report was to compare the clinical manifestations and outcomes of this form of optic neuritis between children and adults.
  
  
  METHODS
  The study sample consisted of all patients diagnosed with parainfectious optic neuritis evaluated by 2 neuro-ophthalmology services between 2005 and 2012. Data were collected retrospectively from the medical files. Findings were compared between patients aged 0-18 years and 19 years or older.
  
  
  RESULTS
  Ten children (50% female) and 8 adults (50% female) met the study criteria. Mean duration of follow-up was 29.4 months (range, 2-72 months) in the pediatric group and 14.2 months (range, 5-80 months) in the adult group. Respective rates of bilateral disease were 50% and 38%, and all patients had optic disc swelling. The associated pathogen was identified in 60% of the pediatric group, mainly Mycoplasma pneumoniae, and 75% of the adult group, in which no microorganism predominated. The interval from the febrile illness to symptom onset was 6 days (range, 1-14 days) in the pediatric group and 19.5 days (range, 14-30 days) in the adult group. Acute disseminated encephalomyelitis (ADEM) was diagnosed in 40% (4/10) of the children and none of the adults. Final visual outcome was 20/30 or better in all patients. There was a higher frequency of bilateral disease in prepubescent vs postpubescent children.
  
  
  CONCLUSIONS
  Parainfectious optic neuritis is associated with a favorable visual prognosis regardless of age. Children tend to manifest visual symptoms sooner after the antecedent infectious illness and more often bilaterally and in conjunction with ADEM. The causative agent is isolated less frequently in children compared with adults.
authors.affiliation: Department of Ophthalmology (DR, HL), Kaplan Medical Center of Israel, Rehovot, Israel; Hebrew University (DR, HL), Hadassah Medical Center, Jerusalem, Israel; Krieger Eye Research Laboratory (NG-C), Felsenstein Medical Research Center, Petach Tikva, Israel; Pediatric Ophthalmology Unit (NG-C), Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Department of Radiology (JL), Rabin Medical Center; Petach Tikva, Israel; and Sackler Faculty of Medicine (NG-C), Tel Aviv University, Tel Aviv, Israel.
authors.forename: Daniel
authors.initials: D
authors.lastname: Rappoport
authors.forename: Nitza
authors.initials: N
authors.lastname: Goldenberg-Cohen
authors.forename: Judith
authors.initials: J
authors.lastname: Luckman
authors.forename: Hana
authors.initials: H
authors.lastname: Leiba
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009902:Optic Neuritis / Q000188:drug therapy / Q000209:etiology* / Q000821:virology*; D018184:Paramyxoviridae Infections / Q000150:complications* / Q000188:drug therapy; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones