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At least 19 recordsLinked to original sources
PubMed1978

Visual-evoked response differentiation of ischemic optic neuritis from the optic neuritis of multiple sclerosis.

Fifteen patients with ischemic optic neuritis studied electrophysiologically had a characteristic change of marked reduction in the amplitude of the visual-evoked response even when loss of vision was moderate. The optic neuritis of multiple sclerosis rarely produced this change. Occasionally, small increases in the latent period of the visual-evoked response were recorded from the patients with ischemic optic neuritis. The optic neuritis of multiple sclerosis usually produced significant increases in the latent period. When the normal nerve was tested in patients with ischemic optic neuritis, the visual evoked response was normal. In patients with optic neuritis of multiple sclerosis, stimulation of the "normal" nerve usually produced an increase in the latent period similar to that seen when the involved nerve was stimulated.

Aged↗
PubMedDate not supplied

Management of optic neuritis.

To improve understanding and effectiveness of therapy in optic nerve disease, various causes of so-called optic neuritis should be identified when possible. The clinical characteristics of demyelinating optic neuropathy can be contrasted with those of ischemic optic neuropathy, nutritional optic neuropathy, true optic nerve inflammation (e.g., luetic), optic nerve infiltration with tumor, and compression neuropathy caused by adjacent tumor. Radiologic studies and other means of investigating patients with optic neuritis are reviewed. Arguments in favor of, and against, treatment of presumed demyelinating optic neuritis are presented along with representative corticosteroid treatment regimens. The natural tendency toward spontaneous improvement of optic neuritis makes the effect of treatment difficult to assess.

Adrenocorticotropic Hormone↗
PubMed1976

Optic neuritis in relation to multiple sclerosis.

Available estimates of the frequency with which a patient with optic neuritis develops multiple sclerosis range from as low as 13% to as high as 87%. In an effort to obtain a better estimate, a nation-wide study of optic neuritis was carried out in Israel. Patients who fulfilled strict diagnostic criteria of optic neuritis were identified and examined periodically. Between 1955 and 1964, 105 patients were found and on the basis of these, the average annual age-adjusted incidence of optic neuritis in Israel was 0.56 per 10(5) population compared to 1.2 per 10(5) cases of multiple sclerosis per year, i.e. optic neuritis was about half as frequent as multiple sclerosis each year. As with multiple sclerosis, optic neuritis was more common in European immigrants to Israel than Afro-Asian immigrants. During a follow-up interval which ranged from 3.3 to 15.6 years (mean 9.5 years), at least 27 of the 105 patients developed multiple sclerosis (28%). A life-table analysis showed that after 10 years 32.3 +/- 5.6% of patients with optic neuritis would develop multiple sclerosis and, after 14 years, about half would develop multiple sclerosis. Risk of dissemination was highest in those who were youngest when optic neuritis developed. Neither sex nor ethnic background influenced risk significantly. Results of the present study support earlier work using life-table methods carried out in Hawaii which also showed that between 29 and 39% of patients with optic neuritis will develop multiple sclerosis within 10 years of onset. The life-table method is a better predictor of prognosis than newer laboratory techniques such as spinal fluid studies of IgG, kappa-lambda light chain ratios and serum/CSF IgG ratios.

Adolescent↗
PubMed1975

Virus antibody levels in the cerebrospinal fluid from patients with optic neuritis.

Virus antibody levels were studied in the cerebrospinal fluid (CSF) of 58 patients with optic neuritis and 58 control patients with no indication of multiple sclerosis (MS) or infectious disorders of the central nervous system (CNS). The specimens were tested against three different structural components of measles virus with measles hemagglutination inhibition (HI), measles hemolysis inhibition (HLI) and gel precipitation (GP) tests. Measles antibodies occurred in 62 per cent of CSF specimens from patients with optic neuritis, and 21 per cent of the controls. In the specimens from patients with optic neuritis, the positive rate figures were: for rubella HI test 35, parainfluenza-1 HI 16, and Epstein-Barr virus immunofuorescence (IF) 53 per cent. The frequencies in the control group were 10, 10 and 26 per cent, respectively. Serum/CSF antibody ratios below 80 occurred in measles tests in 45 per cent of patients with optic neuritis and 16 per cent of the control group. Some patients with optic neuritis (but none from the control group) had a reduced serum/CSF antibody ratio in more than one measles antibody test, The patients with optic neuritis had a higher frequency of low serum/CSF albumin ratios indicating blood brain barrier damage, There were, however, several patients with a normal serum/CSF albumin ratio but low serum/CSF immunoglobulin G and measles antibody ratios. This supports the hypothesis that local production of measles antibodies takes place in CNS in some patients with optic neuritis as well as in MS patients. The CSF specimens were further tested against 12 other viruses and mycoplasma pneumoniae complement fixation, but there were no positive specimens. New CSF specimens were taken from five patients during optic neuritis, and from seven patients later on during the follow-up because of the appearance of new neurological symptoms. There were no changes in virus antibody levels, except for two patients with an increase of measles virus antibody titres.

Adolescent↗
PubMed1978

Factors influencing the risk of multiple sclerosis developing in patients with optic neuritis.

One-hundred and forty-six patients who had presented with optic neuritis but without evidence of demyelination elsewhere in the nervous system, and in whom no specific cause could be identified, were reassessed clinically between one month and twenty-three years after the onset. Fifty-eight patients (40 per cent) had developed MS. All 146 patients were HLA-typed. Three factors were identified which were significantly associated with the development of MS: positive typing for the HLA antigen BT 101, winter onset of the initial attack of optic neuritis in BT 101-positive patients only, and recurrent attacks of optic neuritis. The application of these results to the individual patient is of limited use. However, recurrent attacks of optic neuritis should be given the same significance in the clinical classification of MS as episodes of demyelination occurring elsewhere in the central nervous system in a patient with a previous attack of optic neuritis. The results suggest that optic neuritis is caused by two different environmental agents or groups of agents and that the agent which is most common in the winter leads to the development of MS in the genetically susceptible individual. The agent more common in the summer is much less likely to cause MS in either suscetible or non-susceptible individuals. The biological role of the HLA system in the handling of foreign antigens is discussed and it is suggested that the presence of the HLA antigens associated with MS confers a specific disadvantage on individuals in the ability to handle infection by the MS causative agent and that this allows damaging immunological processes to develop.

Diagnosis, Differential↗
PubMed1979

Erythrocyte unsaturated fatty acid test (E-UFA test): a biological test to detect optic neuritis as initial feature of multiple sclerosis.

Retrobulbar optic neuritis, though suspicious is not always considered as a possible onset of MS. For this reason we submitted to the E-UFA (erythrocyte unsaturated fatty acid) test, 41 subjects who suffered from one or several episodes of retrobulbar optic neuritis with no other neurological signs. The test was positive in 14 subjects (34, 1%).

Adolescent↗
PubMed1975

Virus antibody levels in serum specimens from patients with optic neuritis and from matched controls;.

Virus antibody levels in serum specimens taken in acute and convalescent phases from 77 patients with optic neuritits were tested by measles hamagglutination inhibition (HI), measles hemolysis inhibition (HLI), rubella HI, parainfluenza-1 HI, Epstein-Barr immunofluorescence (IF), and against 11 other viruses and mycoplasma pneumoniae with the complement fixation (CF) technique. The virus antibody levels were indicated to be usually very stable, and a fourfold change in virus antibody levels was demonstrated in only eight patients. The virus antibody levels were compared with specimens from two carefully selected control groups. The first control group consisted of 71 healthy persons matched in age, sex and place of residence with the patients with optic neuritis. The other control group consisted of 58 patients with various neurological diseases other than multiple sclerosis (MS) or infectious diseases of the central nervous system. The patients with optic neuritis had significantly higher measles antibody titres than the two control groups in both measles HI and measles HLI tests. Also in 33 patients with optic neuritis of unknown cause, the measles antibody levels were higher than in the control groups. On the other hand, various other antibody tests showed no statistically significant differences between patients with optic neuritis and the control group.

Acute Disease↗
PubMed1976

Relation between Genetic markers and oligoclonal IgG in CSF in optic neuritis.

Thirty patients with acute, unilateral optic neuritis (ON), where re-examination after a mean observation period of 5 years did not reveal any aetiology, were investigated with regard to laboratory abnormalities frequently observed in multiple sclerosis. Eleven patients had oligoclonal IgG in CSF. In 5 of these a measles virus antibody response within the CNS was demonstrable. The remaining 19 patients did not display oligoclonal CSF IgG, nor an antibody response. The major histocompatibility antigens HL-A3 and HL-A7 occurred at similar frequencies in ON and in controls, irrespective of the presence of oligoclonal CSF IgG. The HL-A7 associated MLC determinant LD-7a occurred in ON at a frequency between that observed in controls and in MS. However, an association of the same magnitude as observed in MS was found between ON with oligoclonal CSF IgG and the presence of LD-7a. This association was absent in those ON patients who lacked oligoclonal CSF IgG. The present data indicate that the finding of oligoclonal CSF IgG may increase the risk of developing MS.

Adolescent↗
PubMed1977

Experimental allergic optic neuritis in guinea pigs: preliminary report.

An experimental model for acute allergic optic neuritis was produced in adult strain 13 guinea pigs by sensitization with isogenic spinal cord emulsion in complete Freund's adjuvant. These animals exhibited two distinct clinical patterns: (1) "retrobulbar optic neuritis," with a diminished pupillary response to light despite a normal fundus, and (2) "neuroretinitis," with a diminished pupillary response associated with hyperemia and swelling to the disc and juxtapapillary retinal edema. Histopathologic study of those animals with "retrobulbar neuritis" revealed that some had no abnormalities in the optic nerve or chiasm, but showed foci of mononuclear cell infiltration in the brain. Others had a mononuclear cell infiltration localized to the retrobulbar portion of the optic nerve and chiasm with multiple foci of axial and periaxial demyelination. Similar pathologic changes were present in the animals with "neuroretintis", but the lesions were located just behind the lamina scleralis. These animals also exhibited marked swelling of the axons at the lamina retinalis. On examination by light microscopy, the alterations in the region of optic nerve head appeared characteristic of papilledema.

Animals↗
PubMed1979

The afferent pupillary defect in acute optic neuritis.

Twenty-two patients with acute optic neuritis were studied by the techniques of infrared pupillometry and visual evoked responses (VER) to pattern reversal. A relative afferent pupillary defect was found in all cases and the magnitude of this defect was found to be related to the amplitude, but not to the latency, of the VER. During follow-up the afferent defect was found to remain persistently abnormal while other methods of clinical evaluation could not demonstrate abnormality reliably. The amplitude of the VER also remained low.

Acute Disease↗
PubMed1979

[Optic neuritis in childhood (author's transl)].

The symptoms and signs of twenty-one children under 15 years of age with optic neuritis are presented here. The optic neuritis often was bilateral and accompanied by papilledema. In the acute stage there was however no typical central scotoma in every case. Some children had only peripheral visual field defects. The visual disorder will not improve so much as is general assumed: a slight decrease of visus and visual field defects in static perimetry usually persist. Half of the children developed signs of multiple sclerosis within a few years.

Adolescent↗
PubMed1978

Optic neuritis complicating measles, mumps, and rubella vaccination.

A 6-year-old boy developed bilateral optic neuritis with decreasing visual acuity 18 days after administration of live attenuated trivalent measles, mumps, and rubella vaccine. The patient was treated with oral corticosteroids. The optic neuritis resolved within several weeks and normal vision returned. An afferent pupillary defect persistent in the more severely involved eye for 14 months following vaccination.

Adult↗
PubMed1978

Pulfrich pendulum phenomenon in patients with a history of acute optic neuritis.

The Pulfrich phenomenon is a stereoillusion in which a pendulum swinging at right angles to the line of gaze appears to be describing an elliptical path when absorbing filters are placed in front of one eye. We used two sets of polaroid glasses as adjustable filters. A spot on a modified oscilloscope served at a pendulum bob. Twenty-nine former patients with a history of optic neuritis and visual acuities of greater than or equal to 6/6 in both eyes and twenty-two normal subjects underwent examinations. The patients showed pathological recordings which separated them from the control subjects. The test seems to expose minor residual dysfunction of affected optic nerves where the visual acuity is normalized. This abnormal response when viewing the moving Pulfrich pendulum is probably caused by disturbed neural conduction. The degree of acute visual loss and the time elapsed since the attack did not seem to influence the Pulfrich response. The results may explain why some patients who have recovered from optic neuritis complain of difficulties when viewing moving objects. In addition to the use of Pulfrich illusion test for diagnostic work; i.e. clinical or subclinical attacks of optic neuritis, it can serve as a valuable supplement to the more sophisticated method of visual evoked response.

Acute Disease↗
PubMed1977

Treatmenf of optic neuritis by retrobulbar injection of triamcinolone.

In a single-blind controlled clinical trial patients with optic neuritis caused by demyelination were given a single retrobulbar injection of triamcinolone. Though the treated group showed a trend towards more rapid recovery of vision than the controls, there was no significant difference in visual acuity, colour vision, or visual fields during the first six months after treatment. We conclude that routine use of corticosteroids is not justified in unilateral optic neuritis when vision in the other eye is good. Shortening the period of visual disability in bilateral disease or unilateral disease when vision in the other eye is poor, however, may be justifiable.

Adolescent↗
PubMed1979

A prospective study of the risk of developing multiple sclerosis in uncomplicated optic neuritis.

We prospectively studied 60 patients with uncomplicated optic neuritis (ON) to determine the risk of subsequent multiple sclerosis (MS). All patients were followed for at least 5 years (mean, 7.1 years). Seventeen patients (28 percent) developed definite MS and four (7 percent) developed probable or possible MS. Six of the 17 patients who developed definite MS did so within the first year. Forty-five percent of the women but only 11 percent of the men developed MS. Both sexes were at highest risk if the ON occurred between the ages of 21 and 40. Fifty-one percent of patients in this age group progressed to MS, whereas the risk for others was 12 percent. There was an overall increased risk of MS with recurrent ON. The course of the MS appeared to be benign during the period of observation.

Adolescent↗