Clinical features and outcome of childhood optic neuritis at Queen Sirikit National Institute of Child Health.

Objective: To study the clinical features, treatment, outcome and factors affecting the outcome of optic neuritis in children.

Methods: Children under 16 years of age diagnosed with optic neuritis (ON) at Queen Sirikit National Institute of Child Health over an 11-year period were reviewed. Demographic data, clinical characteristics, treatment and the outcome were analyzed.

Results: Thirty-one patients fulfilled the inclusion criteria. Mean age of onset was 9.2 years. Female to male ratio was 1.8:1. All cases had vision loss, bilateral 74.2% and monocular 25.8%, including decreased color vision 35% disc edema 54.8% and ocular pain 38.7%. The mean duration of follow-up was 20.38 months. The final diagnosis of these patients were 2 multiple sclerosis (MS), 2 neuromyelitis optica (NMO), 3 acute disseminated encephalomyelitis (ADEM) and 24 or isolated optic neuritis (ION). There was no statistically significant difference in gender, age of onset, number of ocular involvement, severity of visual acuity impairment, presented preceding infection, associated symptoms, CSF pleocytosis, high protein in CSF, abnormal brain or eye MRI. 93.3% of patients had clinical improvement, including 70% complete recovery visual acuity of both eyes. The statistically significance was that complete remission in females was more than in males.

Conclusions: Childhood optic neuritis had bilateral vision loss and complete recovery. Females with optic neuritis had statistical significance with complete recovery, more than males.