Abstract Details

Title Demographics, Etiologies, and Visual Outcomes in Pediatric Optic Neuritis at a Large Children’s Hospital

Topic Autoimmune Neurology

Presentation(s) P1 - Poster Session 1 (12:00 PM-1:00 PM)

Poster/Presentation
Number 043

Objective

To characterize etiologies and visual outcomes in children with first-time optic neuritis.

Background

Optic neuritis (ON) is an inflammatory disorder of the optic nerve that may be isolated or indicative of underlying CNS demyelination. Visual outcomes in children are incompletely understood and prior pediatric studies are limited to a period before the routine workup of MOGAD. We therefore evaluated the etiologies and visual outcomes of all pediatric first-time ON at a quaternary pediatric hospital.

Design/Methods This is a single-center, retrospective study of pediatric first-time ON between 2015-2023. We compared demographics, diagnoses, and visual acuity (VA) at presentation and at follow up. We converted visual acuities to LogMAR based on prior studies in order to obtain an aggregate mean. This study was approved by the BCM IRB.

Results Sixty-three children presented to our institution with first-time ON. 11/63 were immediately diagnosed with MS and 5/63 with NMOSD due to other demyelinating lesions on initial imaging while 47/63 had isolated ON. 53.2% of isolated ON cases were due to MOGAD. Initial VA was the worst in patients with NMOSD followed by those with MOGAD and idiopathic ON, while MS patients presented with the least poor VA. Younger children (1-7 years old) presented to healthcare sooner following their ON symptom onset than did older children (8+ year old). Final VA at follow up was better in younger than older children (LogMAR 0.07 +/- 0.04 corresponding to nearly 20/20 vision vs 0.25 +/- 0.9 corresponding to about 20/40 vision).

Conclusions

We found younger children presented to healthcare with ON sooner following the onset of ON than did older children and had better visual outcomes. MOGAD is responsible for considerably more isolated ON than previously thought and MS tends to have better VA than the other etiologies of pediatric ON. More research is needed on management of pediatric ON.

Authors/Disclosures
Chaitanya Aduru, Medical Student PRESENTER	Mr. Aduru has nothing to disclose.
Akansha Chandrasekar	Ms. Chandrasekar has nothing to disclose.
Kyla M. Fergason, Medical Student	Miss Fergason has nothing to disclose.
Jonathan S. Rosen	Mr. Rosen has nothing to disclose.
Madhuri Chilakapati	Madhuri Chilakapati has nothing to disclose.
Rod Foroozan	No disclosure on file
Timothy E. Lotze, MD, FAAN (Texas Children's Hospital)	Dr. Lotze has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Department of Justice VICP. The institution of Dr. Lotze has received research support from NIH. The institution of Dr. Lotze has received research support from National MS Society. The institution of Dr. Lotze has received research support from Sarepta Therapeutics. The institution of Dr. Lotze has received research support from PTC THERAPEUTICS. The institution of Dr. Lotze has received research support from Avexis. Dr. Lotze has received publishing royalties from a publication relating to health care. Dr. Lotze has received publishing royalties from a publication relating to health care.
Jonathan Yarimi, MD (Memorial Healthcare)	Dr. Yarimi has nothing to disclose.
Nikita Shukla, MD (BCM)	The institution of Dr. Shukla has received research support from Roche.
Kristen Fisher, DO (Baylor College of Medicine)	Dr. Fisher has nothing to disclose.
Alexander Sandweiss, MD, PhD	Dr. Sandweiss has nothing to disclose.

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