Çocukluk Çağı Optik Nöritlerinde Etiyolojik Dağılım ve Etiyolojiye Göre Prognoz: Çok Merkezli Retrospektif Araştırma

Abstract

The aim was to determine the demographic, clinical, laboratory characteristics, and prognostic factors of demyelinating autoimmune optic neuritis (ON) in pediatric patients. Pediatric ON cases diagnosed in three pediatric neurology clinics in Turkey, who underwent neuro-ophthalmological examination and OCT (Optical Coherence Tomography) tests, were retrospectively evaluated. The data of 30 patients, including 18 girls (60%) and 12 boys (40%), who met the inclusion criteria were analyzed. The mean age at the time of inclusion was 13.83 ± 2.98 years (range: 7–17.7). The average follow-up time for these patients was 9.73 ± 9.77 months (range: 4–57). Of the patients presenting with an ON attack, 8 (26.7%) had isolated ON, 9 (30%) were diagnosed with Multiple Sclerosis (MS), 4 (13.3%) with Neuromyelitis Optica Spectrum Disorder (NMOSD), 7 (23.3%) with Myelin Oligodendrocyte Glycoprotein Associated Disease (MOGAD), and 2 (6.7%) with Chronic Recurrent Inflammatory Optic Neuropathy (CRION). Visual prognosis was assessed at the 3rd and 6th months. In cases that required combined treatment, incomplete recovery was observed in patients who were unresponsive to pulse steroids. Particularly, the most damage and lack of complete recovery were observed in the NMOSD and CRION groups in the eye examinations at both initial and follow-up visits. OCT imaging was performed twice at specified intervals for the patients who had an ON attack. There was no statistically significant difference between the groups in both baseline and follow-up OCT data, except for the superior retinal nerve fiber layer (RNFL) in the control OCT. When looking at the RNFL thickness, the group with the most thinning was the NMOSD group. Long-term follow-up studies investigating etiological and diagnostic markers may be useful for further defining this group.