Frontiers in Neurology (Sep 2022)

Early predictors of visual and axonal outcomes after acute optic neuritis

  • Minh N. L. Nguyen,
  • Minh N. L. Nguyen,
  • Chao Zhu,
  • Scott C. Kolbe,
  • Helmut Butzkueven,
  • Helmut Butzkueven,
  • Owen B. White,
  • Owen B. White,
  • Joanne Fielding,
  • Trevor J. Kilpatrick,
  • Gary F. Egan,
  • Alexander Klistorner,
  • Anneke van der Walt,
  • Anneke van der Walt

DOI
https://doi.org/10.3389/fneur.2022.945034
Journal volume & issue
Vol. 13

Abstract

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BackgroundPredicting long-term visual outcomes and axonal loss following acute optic neuritis (ON) is critical for choosing treatment. Predictive models including all clinical and paraclinical measures of optic nerve dysfunction following ON are lacking.ObjectivesUsing a prospective study method, to identify 1 and 3 months predictors of 6 and 12 months visual outcome (low contrast letter acuity 2.5%) and axonal loss [retinal nerve fiber layer thickness and multifocal evoked potential (mfVEP) amplitude] following acute ON.MethodsIn total, 37 patients of acute ON onset were evaluated within 14 days using between-eye asymmetry of visual acuity, color vision (Ishihara plates), optical coherence tomography, mfVEP, and optic nerve magnetic resonance imaging [magnetic transfer ratio (MTR) and diffusion tensor imaging (DTI)].ResultsVisual outcome at 6 and 12 months was best predicted by Ishihara asymmetry at 1 and 3 months following ON onset. Axonal loss at 6 and 12 months was reliably predicted by Ishihara asymmetry at 1 month. Optic nerve MTR and DTI at 3 months post-acute ON could predict axonal loss at 6 and 12 months.ConclusionsSimple Ishihara asymmetry testing 1 month after acute ON onset can best predict visual outcome and axonal loss at 6 and 12 months in a clinical or research setting.

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