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We investigated the paraclinical profile of monosymptomatic optic neuritis (ON)and its prognosis for multiple sclerosis(MS).The correct identification of patients with very early MS carrying a high risk for conversion to clinically definite MS is important when new treatments are emerging that hopefully will prevent or at least delay future MS.We conducted a prospective single observer and population-based study of 147 consecutive patients(118 women,80%)with acute monosymptomatic ON referred from a catchment area of 1.6 million inhabitants between January 1,1990 and December 31,1995.Of 116 patients examined with brain MRI,64(55%)had three or more high signal lesions,11(9%)had one to two high signal lesions,and 41(35%)had a normal brain MRI.Among 143 patients examined, oligoclonal IgG(OB)bands in CSF only were demonstrated in 103 patients (72%).Of 146 patients analyzed,68(47%)carried the DR15,DQ6,Dw2 haplotype. During the study period,53 patients(36%)developed clinically definite MS. The presence of three or more MS-like MRI lesions as well as the presence of OB were strongly associated with the development of MS(p<0.001).Also, Dw2 phenotype was related to the development of MS(p=0.046).MRI and CSF studies in patients with ON give clinically important information regarding the risk for future MS. |
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cerebrospinal fluid cerebrospinal fluid,abnormal cerebrospinal fluid,gammaglobulin of cerebrospinal fluid,oligoclonal IgG in HLA MRI MRI,abnormal multiple sclerosis multiple sclerosis,risk factors for optic neuritis prognosis risk factors
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