Lebranchu Pierre, Mazhar Driss, Wiertlewski Sandrine, Le Meur Guylène, Couturier Justine, Ducloyer Jean-Baptiste
Nantes Université, Service d'ophtalmologie CHU Nantes, Ecole Centrale Nantes, LS2N, UMR6004, F-44000 Nantes, France.
Nantes Université, Service d'ophtalmologie CHU Nantes, F-44000 Nantes, France.
Mult Scler Relat Disord. 2025 Jan;93:106213. doi: 10.1016/j.msard.2024.106213. Epub 2024 Dec 9.
The last updates to diagnostic criteria for multiple sclerosis (MS) included a diagnostic category of 'possible MS'. However, no recent data is available to assess how much this distinction helps predict MS after isolated optic neuritis (ON). This study aimed to assess the global risk of developing MS one year after a first ON episode, and the specific risk according to the initial diagnosis of isolated ON or ON with possible MS.
One-year follow-up of a multicentric prospective cohort of adult patients with acute ON.
This study included 55 patients with acute ON of no known etiological diagnosis. Overall, the final diagnosis at one year was MS (23, 42 %), MOGAD (7, 13 %), NMOSD (1, 2 %), CRION (3, 5 %), possible MS (6, 11 %), secondary ON (3, 5 %), and strictly isolated ON (12, 22 %). Three of the 17 (18 %) patients with strictly isolated ON and 2/8 (25 %) with possible MS at baseline progressed to MS. All secondary MS diagnosis were made through radiological monitoring.
One year after the first ON episode, we observed a similar conversion rate to MS for patients with strictly isolated ON and possible MS, with a higher prevalence of MS than found by the ONTT.
多发性硬化症（MS）诊断标准的最新更新纳入了“可能的MS”这一诊断类别。然而，目前尚无近期数据可评估这种区分对孤立性视神经炎（ON）后MS预测的帮助程度。本研究旨在评估首次ON发作一年后发生MS的总体风险，以及根据孤立性ON或可能的MS的初始诊断得出的具体风险。
对成年急性ON患者的多中心前瞻性队列进行为期一年的随访。
本研究纳入了55例病因不明的急性ON患者。总体而言，一年后的最终诊断为MS（23例，42%）、MOGAD（7例，13%）、NMOSD（1例，2%）、CRION（3例，5%）、可能的MS（6例，11%）、继发性ON（3例，5%）和严格孤立性ON（12例，22%）。基线时17例严格孤立性ON患者中有3例（18%）和8例可能的MS患者中有2例（25%）进展为MS。所有继发性MS诊断均通过影像学监测做出。
首次ON发作一年后，我们观察到严格孤立性ON和可能的MS患者向MS的转化率相似，MS的患病率高于视神经炎治疗试验（ONTT）的结果。
