Long-term follow-up of isolated optic neuritis: the risk of developing multiple sclerosis, its outcome, and the prognostic role of paraclinical tests
Long-term follow-up of isolated optic neuritis: the risk of developing multiple sclerosis, its outcome, and the prognostic role of paraclinical tests
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DOI：
10.1007/s004150050453
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发表时间：
1999-09-01
影响因子：
6
通讯作者：
Canal, N
中科院分区：
文献类型：
--
作者：
Ghezzi, A;Martinelli, V;Canal, N
我们评估了112例孤立性视神经炎（ON）急性发作后发展为临床确诊的多发性硬化（CDMS）的风险，并与人口统计学和临床辅助检查结果相关联。对患者进行了脑部磁共振成像（MRI）、脑脊液（CSF）分析和多种诱发电位（EPs）检查；10例患者失访，其余102例纳入一项前瞻性研究（随访时间为6.3±2.2年）。其中，37例（36.3%）在平均2.3±1.6年的间隔后发展为CDMS。2年后发展为CDMS的风险为13%，4年后为30%，6年后为37%，8年和10年后为42%。性别、年龄和视神经炎发作季节不影响该风险。71例有1个或多个MRI病灶的患者中有37例（52.1%）发生了多发性硬化；MRI正常的患者无一人发病。有鞘内IgG合成的患者比无鞘内IgG合成的患者多发性硬化发病更频繁（43%对28%），但差异无统计学意义。多种诱发电位仅下肢躯体感觉诱发电位显示出轻微的预测价值。大多数病例中多发性硬化病情较轻（扩展残疾状态量表（EDSS）评分2.2±1.9）。32例（86%）EDSS评分小于4，2例（5%）在4到6之间，3例（8%）高于6.5。
We evaluated the risk of developing clinically definite multiple sclerosis (CDMS) after an acute attack of isolated optic neuritis (ON) in 112 patients, in relation to demographic and paraclinical findings. Patients were examined by brain MRI, CSF analysis, and multiple evoked potentials (EPs); 10 were lost to follow-up, and the other 102 were enrolled in a prospective study (follow up duration 6.3 +/- 2.2 years). Of these, 37 (36.3%) developed CDMS after a mean interval of 2.3 +/- 1.6 years. The risk of developing CDMS was 13% after 2 years, 30% after 4, 37% after 6, and 42% after 8 and 10 years. Gender, age. and season of ON onset did not affect the risk. MS occurred in 37 of 71 patients (52.1%) with one MRI lesion or more; no patient with a normal MRI developed the disease. MS developed more frequently in patients with intrathecal IgG synthesis than in those without (43% vs. 28%), but the difference was not statistically significant. Multiple EPs showed a slight predictive value only including somatosensory EPs of the lower limb. Multiple sclerosis was mild in most cases (EDSS 2.2 +/- 1.9). The EDSS was less than 4 in 32 cases (86%), between 4 and 6 in 2 (5%), higher than 6.5 in 3 (8%).