RISK-FACTORS FOR DEVELOPING MULTIPLE-SCLEROSIS AFTER CHILDHOOD OPTIC NEURITIS

We reviewed the records of all children (younger than 16 years of age) who presented with a diagnosis of optic neuritis (ON) identified thro ugh the comprehensive records-linkage system at the Mayo Clinic and id entified 94 cases between 1950 and 1988 with a documented history of i diopathic ON. Detailed follow-up information was available on 79 patie nts, with a median length of follow-up of 19.4 years. Life-table analy sis showed that 13% of the 79 patients with isolated ON had progressed to clinically or laboratory-supported definite multiple sclerosis (MS ) by 10 years of follow-up, 19% by 20 years, 22% by 30 years, and 26% by 40 years. Gender, age, funduscopic findings, visual acuity, or fami ly history of either ON or MS did not predict the development of MS. T he presence of bilateral sequential or recurrent ON increased the risk of developing MS (p = 0.002; hazard ratio = 5.09), whereas the presen ce of infection within 2 weeks before the onset of ON decreased the ri sk of developing MS (p = 0.060; hazard ratio = 0.24). This study of ch ildhood ON supports the lower risk of recurrence and progression to MS compared with adults.