A Comparison of Clinical Manifestations of Idiopathic Optic Neuritis in Korean and Western Patients: A Single-center Experience
Manyong Lee, MD, In Soo Joo, MD
Department of Neurology, Ajou University School of Medicine, Suwon, Korea
Background: Idiopathic optic neuritis (ION) could be the first manifestation of central demyelinating diseases such as multiple sclerosis (MS) and neuromyelitis optica. The prevalence of these dis- eases is different across ethnic groups. The purpose of this study was to identify whether clinical manifestations of ION were different between Korean and Western patients.
Methods: Thirty-two patients with ION were recruited from January 2011 to December 2018. The mean follow-up period was 12 months. We analyzed demographics, clinical symptoms, radiologic findings, and prognosis. These data were compared to those of a Western group (the Optic Neuritis Treatment Trial).
Results: The mean age of Korean onset was 32.8 years, similar to the Western group (32.8 vs. 31.8). Female to male ratio was similar at about 2:1 in both groups (71.9% vs. 77.2%). The rate of orbital pain was lower for Koreans compared to Westerns (64.5% vs. 92.2%), but papilledema was higher (81.3% vs. 35.3%). The proportion of final visual acuity over 0.5 was 93.1% and 92%, with both groups showing good prognosis. There were three Korean patients who developed MS, and risk fac- tors for MS were asymptomatic brain MRI abnormality, increased immunoglobulin G (IgG) index, positive oligoclonal band, and cerebrospinal fluid (CSF) pleocytosis.
Conclusion: Korean patients with ION frequently showed papillitis rather than retrobulbar optic neu- ritis, which were common in Western patients. The transition to MS was rare in Korean ION patients. But if they had a brain MRI abnormality, increased IgG index, positive oligoclonal band, and CSF pleocytosis at the time of diagnosis, they should be carefully observed to identify progress to MS.
Journal of Multiple Sclerosis 10(1):7-13, 2019
