Title: Study on Clinical and Neuroradiological Profile on Patients of Optic Neuritis in Central India
Authors: Prof. Dr T.N. Dubey, Ankit Gupta
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.105
Abstract
Introduction: Optic neuritis (ON) is an acute inflammatory disorder of the optic nerve. The disease is characterized by unilateral or bilateral acute diminuition of vision, often accompanied by periocular pain maximally associated with eye movements. The majority of cases are idiopathic in origin. This study was undertaken to evaluate the clinical, neuroradiological, electrophysiological profile on patients of optic neuritis in context of various studies.
Materials: The study is an observational study. The study was carried out in OPD patients and admitted patients in department of medicine and department of Ophthalmology ,Gandhi Medical College, Bhopal and and associated Hamidia Hospital Bhopal (M.P.).Patients presenting with unilateral or bilateral diminuition of vision less than 4 weeks, presence of relative afferent pupillary defect, dyschromatopsia and normal or swollen optic disc on fundus examination were included in this study.Optic neuropathies like ischemic, toxic, hereditary, compressive and patients under age of 15 years were excluded from study. All patients were subjected to history, clinical examination, visual evoked potential (VEP), MRI brain with orbit.
Observations: 75 eyes of 61 patients were examined. Mean age was 35.29 years .Female preponderance was seen(65.5%). All patients presented with diminuition of vision less than 4 weeks, and defective colour vision. Bilateral involvement seen in 14 patients (23%). Papillitis (58% of eyes) was most common fundus finding. Prolonged P100 latency was seen in 44 patients (72%) on VEP.MRI Brain showed intracranial demyelination in 23patients(38%).MRI Orbit showed abnormal findings in 77% patients
Conclusions: Majority of patients of Optic neuritis of Central India presented with poor visual acquity. Papillitis is frequently seen in patients. Prolonged P100 latency is most common finding seen on VEP. Therefore, VEP, MRI Brain with Orbit is highly recommended in patients of ON for proper management. Clinical profile of ON in Central India patients is different from that seen in Western population.
Keywords: Optic neuritis,multiple sclerosis, relative afferent papillary defect, visual evoked potential.
References
1. Beck RW, Cleary PA. Optic Neuritis Study G. Optic neuritis treatment trial: one-year follow-up results.Arch Ophthalmol. 1993; 111(6):773–5. ]
2. Jain IS, Munjal VP, Dhir SP, Gangwar DN. Profile of optic neuritis in Chandigarh and surrounding areas. Indian J Ophthalmol. 1980;28:195–200.
4. Kupersmith MJ, Gal RL, Beck RW, Xing D, Miller N. Optic Neuritis Study Group. Visual function at baseline and 1 month in acute optic neuritis: predictors of visual outcome. Neurology. 2007;69:508–1
5. Saxena R, Phuljhele S, Menon V, Gadaginamath S, Sinha A, Sharma P. Clinical profile and short-term outcomes of optic neuritis patients in India. Indian J Ophthalmol 2014;62:265-7
6. Clinical Profile and Aetiology of Optic Neuritis in Hospital Universiti Sains Malaysia – 5 Years Review Ismail Shatriah, Wan Hazabbah Wan Hitam, Muhd-Nor Nor-Idahriani, Daud Jakiyah, Embong Zunaina, Med J Malaysia Vol 67 No 2 April 2012
7. A clinical case study on short term visual outcome of optic neuritis with IV Methyl prednisolone C.Sreenivasulu, K. vidyasagar. Indian journal of applied research volume 6 issue 2 February 2016 387-389
8. The role of magnetic resonance imaging and visual evoked potential in management of optic neuritis .Suha mikail al –ejailat, Mousa victor Al-madani senior Pan African medical journal 2014
9. Lim SA, Goh KY, Tow S, Fu E, Wong TY, Seah A, et al. Optic neuritis in Singa-pore. Singapore Med J 2008;49:667-71.
10. Liu GT. Visual loss: optic neuropathies. In: Neuro-Ophthalmology: Diagnosis and Management, Liu GT, Volpe NJ, Galetta SL (Eds),WB Saunders,Philadelphia 2001.
11. Wray, SH. Optic neuritis. In: Principles and Practice of Ophthalmology, Albert, DM, Jakobiec, FA (Eds), WB Saunders, Philadelphia 1994. p.2539.
12. The clinical profile of optic neuritis. Experience of the Optic Neuritis Treatment Trial. Optic Neuritis Study Group. Arch Ophthalmol 1991; 109:1673.
13. Percy AK, Nobrega FT, Kurland LT. Optic neuritis and multiple sclerosis. An epidemiologic study. Arch Ophthalmol 1972; 87:135.
14. Rodriguez M, Siva A, Cross SA, et al. Optic neuritis: a population-based study in Olmsted County, Minnesota. Neurology 1995; 45:244.
15. Phillips PH, Newman NJ, Lynn MJ. Optic neuritis in African Americans. Arch Neurol 1998; 55:186.
16. Wakakura M, Minei-Higa R, Oono S, et al. Baseline features of idiopathic optic neuritis as determined by a multicenter treatment trial in Japan. Optic Neuritis Treatment Trial Multicenter Cooperative Research Group (ONMRG). Jpn J Ophthalmol 1999; 43:127.
17. von Graefe A. Ueber complication von sehnervenentzundung mit gehirnkran-kheiten. Archiv Ophthalmologie 1860;1: 58–71.
18. Nettleship E. On cases of retro-ocular neuritis. Trans Ophthal Soc UK 1884;4:186–226.
19. Balcer LJ. Clinical practice. Optic neuritis. N Engl J Med 2006; 354:1273.
23. Rosati G. The prevalence of multiple sclerosis in the world: an update. NeurolSci2001;22:117-39