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The following is a summary of “One-year risk of multiple sclerosis after a first episode of optic neuritis according to modern diagnosis criteria,” published in the December 2024 issue of Neurology by Lebranchu et al.  

Optic neuritis (ON), an optic nerve inflammation, can be an early symptom of multiple sclerosis (MS). The updated diagnostic criteria for MS include the category “possible MS,” highlighting the need for early identification to reduce the risk of long-term functional impairment.  

Researchers conducted a prospective study to assess the risk of MS 1 year after the first episode of ON and evaluate the predictive value of the “possible MS” diagnosis.  

They followed a multicenter cohort of 55 adults who experienced acute ON and had no known underlying diagnosis. Participants were classified as having strictly isolated ON (no brain magnetic resonance imaging [MRI] abnormalities and no oligoclonal bands detected in cerebrospinal fluid [CSF]) or possible MS, follow-up assessments were conducted at 1 year.  

The results showed 42% (23 out of 55) of individuals were diagnosed with MS after 1 year. Other diagnoses included myelin oligodendrocyte glycoprotein-associated disease (MOGAD, 13%), neuromyelitis optica spectrum disorder (NMOSD, 2%), chronic relapsing inflammatory optic neuropathy (CRION, 5%), secondary ON (5%), and strictly isolated ON (22%). Among individuals with strictly isolated ON at baseline, 18% (3 out of 17) developed MS, while 25% (2 out of 8) with possible MS progressed to MS. All MS diagnoses were confirmed through radiological monitoring.  

They concluded that 1 year after the first ON episode, the risk of MS was higher than previously reported. Regular screening for MS was recommended for all individuals with ON, even when initial MRI and CSF findings do not indicate abnormalities.  

Source: msard-journal.com/article/S2211-0348(24)00789-2/fulltext