Abnormal MRI, cerebrospinal fluid may predict MS progression in pediatric ON

This study of children with isolated optic neuritis (ON) found a strong association between initial cerebrospinal fluid and cranial magnetic resonance imaging (cMRI) results and the risk of conversion to multiple sclerosis (MS), with the odds of developing MS in this population increasing significantly if both are abnormal. The authors conclude that MS-like cMRI lesions and spinal fluid oligoclonal bands (OCB) appear useful for assessing the risk of progression to MS following isolated ON in children.

They conducted a retrospective chart review of 34 children presenting with isolated ON and examined their risk of conversion to MS using cMRI, visual evoked potentials (VEPs) and OCB as predictive factors.

Abnormal cMRI was significantly associated with increased odds of developing MS, as was positive OCB. However, only cMRI remained statistically significant in multivariate analysis.

The authors say these predictors could form the basis of a quantitative prediction model through which patients' risk of conversion to MS might be quantified.

They say that the potential use of these factors as diagnostic tools for clinicians to identify children at high risk of conversion to MS has not been previously reported. Nevertheless, prospective multicenter studies incorporating cMRI data, OCB and long-term follow-up intervals are needed to further determine the risk factors associated with the development and course of MS after pediatric ON and to evaluate cMRI and CSF as prognostic outcome tools for ON patients.