Multiple sclerosis risk after optic neuritis: Final optic neuritis treatment trial follow-up

Michael Brodsky, Sarkis Nazarian, Silvia Orengo-Nania, George J. Hutton, Edward G. Buckley, E. Wayne Massey, M. Tariq Bhatti, Melvin Greer, James Goodwin, Michael Wall, Peter J. Savino, Thomas Leist, Neil R Miller, David Irani, Jonathan D. Trobe, Wayne Cornblath, David I. Kaufman, Eric Eggenberger, Mark J. Kupersmith, William T. ShultsLeslie McAllister, Steve Hamilton, Roy W. Beck, Mariya Dontchev, Robin L. Gal, Craig Kollman, John L. Keltner, Craig H. Smith

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)727-732
Number of pages6
JournalArchives of Neurology
Volume65
Issue number6
DOIs
StatePublished - Jun 2008

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Optic Neuritis
Multiple Sclerosis
Magnetic Resonance Imaging
Therapeutics
Optic Disk
Brain
Optics
Neurologic Examination
Natural History
Nervous System
Lesion
Outcome Assessment (Health Care)
Confidence Intervals

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Brodsky, M., Nazarian, S., Orengo-Nania, S., Hutton, G. J., Buckley, E. G., Massey, E. W., ... Smith, C. H. (2008). Multiple sclerosis risk after optic neuritis: Final optic neuritis treatment trial follow-up. Archives of Neurology, 65(6), 727-732. https://doi.org/10.1001/archneur.65.6.727

Multiple sclerosis risk after optic neuritis : Final optic neuritis treatment trial follow-up. / Brodsky, Michael; Nazarian, Sarkis; Orengo-Nania, Silvia; Hutton, George J.; Buckley, Edward G.; Massey, E. Wayne; Bhatti, M. Tariq; Greer, Melvin; Goodwin, James; Wall, Michael; Savino, Peter J.; Leist, Thomas; Miller, Neil R; Irani, David; Trobe, Jonathan D.; Cornblath, Wayne; Kaufman, David I.; Eggenberger, Eric; Kupersmith, Mark J.; Shults, William T.; McAllister, Leslie; Hamilton, Steve; Beck, Roy W.; Dontchev, Mariya; Gal, Robin L.; Kollman, Craig; Keltner, John L.; Smith, Craig H.

In: Archives of Neurology, Vol. 65, No. 6, 06.2008, p. 727-732.

Research output: Contribution to journalArticle

Brodsky, M, Nazarian, S, Orengo-Nania, S, Hutton, GJ, Buckley, EG, Massey, EW, Bhatti, MT, Greer, M, Goodwin, J, Wall, M, Savino, PJ, Leist, T, Miller, NR, Irani, D, Trobe, JD, Cornblath, W, Kaufman, DI, Eggenberger, E, Kupersmith, MJ, Shults, WT, McAllister, L, Hamilton, S, Beck, RW, Dontchev, M, Gal, RL, Kollman, C, Keltner, JL & Smith, CH 2008, 'Multiple sclerosis risk after optic neuritis: Final optic neuritis treatment trial follow-up', Archives of Neurology, vol. 65, no. 6, pp. 727-732. https://doi.org/10.1001/archneur.65.6.727
Brodsky M, Nazarian S, Orengo-Nania S, Hutton GJ, Buckley EG, Massey EW et al. Multiple sclerosis risk after optic neuritis: Final optic neuritis treatment trial follow-up. Archives of Neurology. 2008 Jun;65(6):727-732. https://doi.org/10.1001/archneur.65.6.727
Brodsky, Michael ; Nazarian, Sarkis ; Orengo-Nania, Silvia ; Hutton, George J. ; Buckley, Edward G. ; Massey, E. Wayne ; Bhatti, M. Tariq ; Greer, Melvin ; Goodwin, James ; Wall, Michael ; Savino, Peter J. ; Leist, Thomas ; Miller, Neil R ; Irani, David ; Trobe, Jonathan D. ; Cornblath, Wayne ; Kaufman, David I. ; Eggenberger, Eric ; Kupersmith, Mark J. ; Shults, William T. ; McAllister, Leslie ; Hamilton, Steve ; Beck, Roy W. ; Dontchev, Mariya ; Gal, Robin L. ; Kollman, Craig ; Keltner, John L. ; Smith, Craig H. / Multiple sclerosis risk after optic neuritis : Final optic neuritis treatment trial follow-up. In: Archives of Neurology. 2008 ; Vol. 65, No. 6. pp. 727-732.
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T1 - Multiple sclerosis risk after optic neuritis

T2 - Final optic neuritis treatment trial follow-up

AU - Brodsky, Michael

AU - Nazarian, Sarkis

AU - Orengo-Nania, Silvia

AU - Hutton, George J.

AU - Buckley, Edward G.

AU - Massey, E. Wayne

AU - Bhatti, M. Tariq

AU - Greer, Melvin

AU - Goodwin, James

AU - Wall, Michael

AU - Savino, Peter J.

AU - Leist, Thomas

AU - Miller, Neil R

AU - Irani, David

AU - Trobe, Jonathan D.

AU - Cornblath, Wayne

AU - Kaufman, David I.

AU - Eggenberger, Eric

AU - Kupersmith, Mark J.

AU - Shults, William T.

AU - McAllister, Leslie

AU - Hamilton, Steve

AU - Beck, Roy W.

AU - Dontchev, Mariya

AU - Gal, Robin L.

AU - Kollman, Craig

AU - Keltner, John L.

AU - Smith, Craig H.

PY - 2008/6

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N2 - 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.

AB - 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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