OPTIC NEURITIS - FINDINGS ON MRI, CSF EXAMINATION AND HLA CLASS-II TYPING IN 60 PATIENTS AND RESULTS OF A SHORT-TERM FOLLOW-UP

Optic neuritis (ON) is a common first manifestation of multiple sclero sis (MS), and examination of patients with ON provides opportunities t o study the early clinical stages of MS. This prospective study compar es results of brain magnetic resonance imaging (MRI), cerebrospinal fl uid (CSF) examinations and HLA-Dw2 phenotyping in 60 consecutive patie nts with ON. At a median of 17 days after the onset of ON, 69% had oli goclonal IgG bands, and at a median on 79 days after onset, 53% had mu ltiple (greater-than-or-equal-to 3) white matter lesions on MRI. Subgr oup analyses revealed that MRI abnormalities and oligoclonal IgG bands were equally common in patients examined early or late after the onse t of ON. Strong correlations were found between the presence of MRI ab normalities and oligoclonal IgG bands. The HLA-Dw2 phenotype was signi ficantly increased in ON patients compared with controls, but also sig nificantly different from a group of MS patients from the same geograp hica) area. A significant relation was found between Dw2 phenotype and oligoclonal IgG bands. During a mean follow-up time of about 2 years, the diagnosis in 17 of the patients changed to clinically definite MS . Initially, 16 of them had oligoclonal IgG bands and 12 had three or more MRI lesions. Both MRI and CSF studies are important diagnostic to ols in the workup of ON patients.