Assessment and Outcomes of Pediatric Optic Neuritis in a Tertiary Children's Hospital in the United Kingdom: A 10-Year Retrospective Review.

Abstract

AimTo define the clinical presentations, visual outcomes, and treatment practices for pediatric optic neuritis at a tertiary children's hospital in the United Kingdom.MethodsA retrospective review was conducted for patients aged 0-16 years diagnosed with optic neuritis over a 10-year period. Demographic and clinical data were retrieved from electronic and archived medical records. Follow-up assessments were completed at intervals of 2 weeks, 3 months, 6 months, 1 year, and 3 years, with a minimum follow-up of 2 weeks.ResultsSixteen patients experienced their first optic neuritis episode, with 81% presenting unilaterally and 19% bilaterally. All patients reported visual loss or blurring; headache, eye pain, and dizziness were also common. Poor visual acuity (>0.3 logMAR) was noted in 78% of eyes at presentation. Relative afferent pupillary defects were observed in 85% of unilateral cases, and initial color vision deficits were present in 64%. Disc swelling affected 46% of unilateral cases. Treatments varied, with all bilateral cases receiving intravenous methylprednisolone followed by oral steroids; 62% of unilateral cases received similar treatment. No optic neuritis recurrences were noted within the study period. Final visual outcomes did not significantly differ across myelin-oligodendrocyte glycoprotein-positive, multiple sclerosis-associated, and isolated pediatric optic neuritis groups.ConclusionPatients with pediatric optic neuritis present with initial poor visual acuity, from which the majority substantially improve within 3 months, though significant further recovery may occur up to 1 year post-presentation. Myelin-oligodendrocyte glycoprotein-positive disease appears to be a significant cause of pediatric optic neuritis. Treatment practices show significant variability; however, the trend for intravenous corticosteroid use continues to predominate.