Retrospective evaluation of pediatric optic neuritis patients

Objective: Accompanying optic neuritis in childhood can be secondary to an isolated event, or it can be seen as a clinical presentation of a demyelinating disease. It was aimed to determine the possible risk factors for demyelinating disease in patients presenting with optic neuritis by evaluating the clinical, laboratory and imaging characteristics of the patients followed up in our hospital with the diagnosis of optic neuritis. Materials and methods: Medical files of patients younger than 18 years old who were treated with the diagnosis of optic neuritis at Karadeniz Technical University Faculty of Medicine between January 1, 2008 and January 1, 2018 were analyzed retrospectively. Results: Isolated optic neuritis in 60.5% (n=26) of optic neuritis patients, MS in 20.9% (n=9), ADEM in 6.9% (n=3), and 4.6% (n=2) NMO was diagnosed in 2.5% (n=1) of MOG antibody disease. 51.2% of the patients were female, and the mean age of the first attack was 12 years. The female gender was statistically higher in the demyelinating disease group than in the isolated ON group (p=0.047). It was observed that female patients mostly applied in the spring-summer season (p=0.003). The incidence of demyelinating disease was found to be statistically significantly higher in patients whose first attack age was > 12 years (p=0.008). Motor findings were found to be significantly higher in the demyelinating group than in the isolated ON group (p=0.037) When the patients diagnosed with demyelinating disease and isolated ON patients were compared, the brain, spinal and orbital MRI findings were found to be statistically highly significant in the demyelinating disease group (p<0.001). When the probability risk in terms of demyelinating disease was calculated, the brain MRI finding was found to be OR: 28.75. In case of optic nerve lesion, OR: 6.25, in case of first attack age >12 years, OR: 5.86, in case of female gender, OR: 4. When the patients diagnosed with MS and the isolated ON group were compared during the follow-up, it was seen that the brain, spinal and orbital MRI findings and the recurrence of attacks v were statistically significantly higher in the MS group. (p<0.001, p<0.001, p=0.023, p=0.009) Attack recurrence was only demyelinating. seen in the group. Bilateral involvement was found to be statistically significantly more common under 12 years of age (p=0.001). Conclusion: The most important risk factor for the development of demyelinating disease is the presence of brain MRI findings at the time of admission in patients presenting with optic neuritis in childhood. However, having spinal MRI findings, optic nerve lesion, female gender, relapse, unilateral involvement and being over 12 years old also increase the risk of demyelinating disease. Key words: Optic neuritis, demyelinating disease, MS, ADEM, NMO, MOG, brain MRI, bilateral