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Abstract Details

Predicting the Final Clinical Phenotype after the First Attack of Optic Neuritis
Multiple Sclerosis
P5 - Poster Session 5 (11:45 AM-12:45 PM)
3-017
ON could be an isolated event or the initial presentation of a chronic neuroimmunological condition. Predicting the eventual clinical phenotype at the time of initial attack can facilitate prognostication and inform management.
To evaluate the factors determining the final clinical phenotype after an initial isolated attack of optic neuritis (ON).
This was a retrospective analysis of patients presenting to University Hospitals Cleveland Medical Center for an initial, isolated attack of ON. Final clinical phenotypes were idiopathic ON, multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), myelin oligodendrocyte glycoprotein associated disease (MOGAD), or secondary ON (e.g. neurosarcoidosis). Univariate analysis was carried out to determine predictors of the final clinical phenotype.
Sixty-four patients met criteria. Average age of onset was 41.3±13.3, 78.1% of patients were females, average time to final diagnosis was 8.3 months, and average follow-up was 47 months. The final phenotypes were MS (22, 34%), idiopathic ON (14, 22%), MOGAD (11, 17%), NMOSD (10, 16%), and secondary ON (7, 11%). Univariate analysis showed white race, unilateral ON, short segment hyperintensity on orbital MRI, and not receiving PLEX was associated with MS. Older age, poor steroid responsiveness, and receiving PLEX was associated with NMOSD. African American race, bilateral ON, papillitis on fundoscopy, and long segment hyperintensity on orbital MRI was associated with MOGAD. Normal or thinned retinal nerve fiber layer on OCT and short segment hyperintensity on orbital MRI were associated with idiopathic ON. The initial visual acuity did not differentiate between final phenotypes at the time of initial presentation.
The final clinical phenotype may be predictable at the time of initial ON presentation. This requires a careful evaluation of patient demographics, treatment response, and findings on fundoscopy, OCT, and orbital MRI. Utilizing early predictors in clinical practice could better inform prognosis and management decisions.
Authors/Disclosures
Shlok Sarin
PRESENTER
Mr. Sarin has nothing to disclose.
Nikhil Modak, MD Dr. Modak has nothing to disclose.
Rongyi *use 384703 Sun Ms. Sun has nothing to disclose.
Mhd. Omar Subei, MD Dr. Subei has nothing to disclose.
Alessandro Serra, MD (University Hospitals Cleveland Medical Center) Dr. Serra has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen Idec. Dr. Serra has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Bristol Myers Squibb.
Michael L. Morgan, MD, PhD (University Hospitals) Dr. Morgan has nothing to disclose.
Hesham Ahmed Abboud, MD (University Hospitals Cleveland Medical Center) Dr. Abboud has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. The institution of Dr. Abboud has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech . Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Horizon. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alpine Pharma. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cycle Pharma. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Axonics. Dr. Abboud has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Abboud has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Genentech. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for BMS. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion . Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Horizon. The institution of Dr. Abboud has received research support from Genentech . The institution of Dr. Abboud has received research support from Novartis. The institution of Dr. Abboud has received research support from BMS. The institution of Dr. Abboud has received research support from Sanofi-Genzyme. The institution of Dr. Abboud has received research support from The Guthy-Jackson Charitable Foundation. Dr. Abboud has received publishing royalties from a publication relating to health care.