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KMID : 1022820190100010007
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Journal of Multiple Sclerosis and Neuroimmunology
2019 Volume.10 No. 1 p.7 ~ p.13
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A Comparison of Clinical Manifestations of Idiopathic Optic Neuritis in Korean and Western Patients: A Single-center Experience
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Lee Man-Yong
Joo In-Soo
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Abstract
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Background: Idiopathic optic neuritis (ION) could be the first manifestation of central demyelinating diseases such as multiple sclerosis (MS) and neuromyelitis optica. The prevalence of these dis- eases is different across ethnic groups. The purpose of this study was to identify whether clinical manifestations of ION were different between Korean and Western patients.
Methods: Thirty-two patients with ION were recruited from January 2011 to December 2018. The mean follow-up period was 12 months. We analyzed demographics, clinical symptoms, radiologic findings, and prognosis. These data were compared to those of a Western group (the Optic Neuritis Treatment Trial).
Results: The mean age of Korean onset was 32.8 years, similar to the Western group (32.8 vs. 31.8). Female to male ratio was similar at about 2:1 in both groups (71.9% vs. 77.2%). The rate of orbital pain was lower for Koreans compared to Westerns (64.5% vs. 92.2%), but papilledema was higher (81.3% vs. 35.3%). The proportion of final visual acuity over 0.5 was 93.1% and 92%, with both groups showing good prognosis. There were three Korean patients who developed MS, and risk fac- tors for MS were asymptomatic brain MRI abnormality, increased immunoglobulin G (IgG) index, positive oligoclonal band, and cerebrospinal fluid (CSF) pleocytosis.
Conclusion: Korean patients with ION frequently showed papillitis rather than retrobulbar optic neu- ritis, which were common in Western patients. The transition to MS was rare in Korean ION patients. But if they had a brain MRI abnormality, increased IgG index, positive oligoclonal band, and CSF pleocytosis at the time of diagnosis, they should be carefully observed to identify progress to MS.
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KEYWORD
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Optic neuritis, Multiple sclerosis, Optic Neuritis Treatment Trial (ONTT) study, Biomarkers, Ethnic groups
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