A long-term prospective study of optic neuritis: evaluation of risk factors

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Eighty-six patients with monosymptomatic optic neuritis of unknown cause were followed prospectively for a median period of 12.9 years. At onset, cerebrospinal fluid (CSF) pleocytosis was present in 46 patients (53%) but oligoclonal immunoglobulin in only 40 (47%) of the patients. The human leukocyte antigen (HLA)-DR2 was present in 45 (52%). Clinically definite multiple sclerosis (MS) was established in 33 patients. Actuarial analysis showed that the cumulative probability of developing MS within 15 years was 45%. Three risk factors were identified: low age and abnormal CSF at onset, and early recurrence of optic neuritis. Female gender, onset in the winter season, and the presence of HLA-DR2 antigen increased the risk for MS, but not significantly. Magnetic resonance imaging detected bilateral discrete white matter lesions, similar to those in MS, in 11 of 25 patients, 7 to 18 years after the isolated attack of optic neuritis. Nine were among the 13 with abnormal CSF and only 2 belonged to the group of 12 with normal CSF (p = 0.01). Normal CSF at the onset of optic neuritis conferred better prognosis but did not preclude the development of MS.


  • Magnhild Sandberg Wollheim
  • Hans Bynke
  • Sten Cronqvist
  • Stig Holtås
  • Per Platz
  • Lars P Ryder
Enheter & grupper

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Radiologi och bildbehandling
  • Oftalmologi
  • Neurologi
Sidor (från-till)386-393
TidskriftAnnals of Neurology
StatusPublished - 1990
Peer review utfördJa