Optic neuritis as onset manifestation of multiple sclerosis - A nationwide, long-term survey

Objective: To determine the predictive value on survival of optic neuritis (ON) as onset manifestation of MS. Methods: We used data obtained from the Danish Multiple Sclerosis Registry, which includes virtually all patients d iagnosed with MS in Denmark. From 1949 to 1990, 7,548 unselected patients f ulfilling standardized diagnostic criteria of MS were registered. Results: The onset manifestation of MS was known in 6,923 patients, and was ON in 1, 282 patients (19%). The mean age at onset was 31.1 years for these patients compared with 34.8 years for patients with another or unknown onset manife station of MS (non-ON) (p < 0.001). The mean delay from the first known man ifestation of MS to the final diagnosis of MS was 6.1 years (ON) and 4.2 ye ars (non-ON). The median survival, time from onset of ON was 30 years in me n (compared with 41 years in the matched general male population) and 40 ye ars in women (versus 47 years). The excess death rate increased with age at onset of MS in people of each sex. Excess death rate for women differed si gnificantly between patients with ON as onset manifestation and patients wi th another or unknown onset manifestation of MS (8.3 versus 13.0). In patie nts with ON as onset manifestation of MS, the excess death rate was signifi cantly higher in men (14.0) than in women (8.3). Conclusion: ON as onset ma nifestation of MS indicates a more favorable prognosis of survival of MS ju dged by excess death rate only in women.