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document
Multiple sclerosis risk after optic neuritis : final optic neuritis treatment trial follow-up . OBJECTIVE To assess the risk of developing multiple sclerosis ( MS ) after optic neuritis and the factors predictive of high and low risk . DESIGN Subjects in the Optic Neuritis Treatment Trial , who were enrolled between July 1 , 1988 , and June 30 , 1991 , were followed up prospectively for 15 years , with the final examination in 2006 . SETTING Neurologic and ophthalmologic examinations at 13 clinical sites . PARTICIPANTS Three hundred eighty-nine subjects with acute optic neuritis . MAIN OUTCOME MEASURES Development of MS and neurologic disability assessment . RESULTS The cumulative probability of developing MS by 15 years after onset of optic neuritis was 50 % ( 95 % confidence interval , 44 % -56 % ) and strongly related to presence of lesions on a baseline non-contrast-enhanced magnetic resonance imaging ( MRI ) of the brain . Twenty-five percent of patients with no lesions on baseline brain MRI developed MS during follow-up compared with 72 % of patients with 1 or more lesions . After 10 years , the risk of developing MS was very low for patients without baseline lesions but remained substantial for those with lesions . Among patients without lesions on MRI , baseline factors associated with a substantially lower risk for MS included male sex , optic disc swelling , and certain atypical features of optic neuritis . CONCLUSIONS The presence of brain MRI abnormalities at the time of an optic neuritis attack is a strong predictor of the 15-year risk of MS . In the absence of MRI-detected lesions , male sex , optic disc swelling , and atypical clinical features of optic neuritis are associated with a low likelihood of developing MS . This natural history information is important when considering prophylactic treatment for MS at the time of a first acute onset of optic neuritis .
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Intervention_Pharmacological
Optic Neuritis Treatment
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Intervention_Physical
brain MRI
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Outcome_Physical
Multiple sclerosis risk
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Outcome_Physical
risk of developing multiple sclerosis ( MS )
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Outcome_Physical
Development of MS
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Outcome_Physical
neurologic disability assessment
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Outcome_Physical
cumulative probability of developing MS by 15 years after onset of optic neuritis
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Outcome_Physical
MS
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Outcome_Physical
risk of developing MS
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Outcome_Physical
risk for MS
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Outcome_Physical
the 15-year risk of MS
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Outcome_Physical
developing MS
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Outcome_Physical
MS
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Participant_Condition
optic neuritis
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Participant_Condition
optic neuritis
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Participant_Sample-size
Three hundred eighty-nine
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Participant_Condition
acute optic neuritis