MS Speaks

[P2.260] Factors Affecting Recovery from Acute Optic Neuritis in Multiple Sclerosis Patients

Muhammad Taimur A. Malik,Brian Healy,Leslie Benson,Pia Kivisakk, Alexander Musallam, Howard Weiner,Tanuja Chitnis

[Brookline MA; Boston MA; USA]

OBJECTIVE:

To determine the severity and recovery from acute optic neuritis (AON) episodes in both the pediatric-onset multiple sclerosis (POMS) and adult-onset multiple sclerosis (AOMS) patients.

BACKGROUND:

AON attacks are common in both POMS and AOMS patients, but the severity and level of recovery from these attacks is variable. Identification of predictors associated with attack severity and recovery may aid in clinical care.

DESIGN/METHODS:

 A sample of AOMS patients with an AON attack as the initial symptom were identified from the CLIMB (n=253), and POMS patients were identified from the Partners Pediatric MS Center (n=38). Another group of patients (n=100) with serum samples within 6 months of AON attack were identified and serum samples analyzed for Vitamin D levels. For each attack, chart review was completed to assess the initial severity of the attack and level of recovery from the attack at one year. Severity was classified based on visual acuity at the visit closest to the attack. AON recovery was classified by change in visual acuity at one year follow-up visit.

The proportion of patients with each level of severity and recovery for the initial AON attack was compared in the two groups using Fisher's exact test. Vitamin D was analysed using Abbott platform.

RESULTS:

Males (adjusted OR=2.28, p=0.03), and subjects with severe attacks had worse recovery (adjusted OR=5.24, p<0.001). AON severity was similar between the pediatric and adult subjects, but recovery was significantly better in pediatric subjects in unadjusted (p=0.041) and analysis adjusted for gender (p=0.029). Season-adjusted vitamin D level was significantly associated with attack severity (OR for 10 unit increase in vitamin D level=0.47; 95% CI: 0.32, 0.68; p<0.001).

CONCLUSIONS:

 Vitamin D levels impact AON severity, while, younger age, attack severity and female gender impacted AON recovery.

_______________
Study Supported by:

NMSS RG-4256A4/2
Category - MS and CNS Inflammatory Disease: Clinical Science

Tuesday, April 29, 2014 7:30 AM