Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Barrow Neurological Institute, Phoenix, AZ, USA.
Mult Scler. 2023 Dec;29(14):1748-1754. doi: 10.1177/13524585231209016. Epub 2023 Nov 9.
Hispanic people compared to White people with multiple sclerosis (MS) are two times more likely to present with optic neuritis (ON). ON in dissemination in space (DIS) after a single attack is not part of the current McDonald 2017 criteria.
To evaluate if adding ON in DIS (ON-modified criteria) improves the performance of the McDonald 2017 criteria in the diagnosis of MS after a single attack of ON.
Retrospective study of 102 patients of Hispanic background. Cases were reviewed between 2017 and 2021. Clinical ON was reported for 35 cases. ON in DIS was verified for 28 patients via MRI, optical coherence tomography, and/or visual evoked potential. We investigated the performance of the McDonald 2017 criteria and ON-modified criteria and calculated sensitivity, specificity, positive and negative predictive values, and accuracy.
The ON-modified criteria significantly improved the performance of the McDonald 2017 criteria ( = 0.003) and identified an additional nine patients. Both sensitivity and accuracy increased from 64% to 74% and 62% to 71%, respectively, while specificity remained unchanged (40% (95% confidence interval (CI): 0.10, 0.70)).
This study provides evidence that the inclusion of ON in DIS improved the overall performance of the McDonald 2017 criteria among Hispanic people.
与多发性硬化症（MS）的白人患者相比，西班牙裔患者出现视神经炎（ON）的可能性高出两倍。单次发作后的弥散空间视神经炎（ON-DIS）不属于当前 2017 年 McDonald 标准。
评估在单次 ON 发作后，添加 ON-DIS（ON 改良标准）是否能提高 McDonald 2017 标准对 MS 的诊断性能。
对 102 名西班牙裔背景的患者进行回顾性研究。病例在 2017 年至 2021 年期间进行了回顾。报告了 35 例临床 ON。通过 MRI、光学相干断层扫描和/或视觉诱发电位对 28 例患者进行了 ON-DIS 的验证。我们研究了 McDonald 2017 标准和 ON 改良标准的性能，并计算了敏感性、特异性、阳性和阴性预测值以及准确性。
ON 改良标准显著提高了 McDonald 2017 标准的性能（ = 0.003），并额外识别了 9 例患者。敏感性和准确性均从 64%增加到 74%和 62%增加到 71%，而特异性保持不变（40%（95%置信区间：0.10，0.70））。
这项研究提供了证据表明，在西班牙裔人群中，纳入 ON-DIS 可提高 McDonald 2017 标准的整体性能。
