Paediatric optic neuritis: experience from a tertiary referral centre in Malaysia

Background: Optic neuritis typically presents with acute or subacute onset of mild or profound blurring of vision. There are very limited reports regarding optic neuritis in the paediatric population compared to adults from the South Asian region. We report a series of 7 cases of paediatric optic neuritis. Methods: All optic neuritis cases aged less than 12 years old in 2016 were studied retrospectively. Results: Out of 44 patients with optic neuritis, 7 of them were of paediatric age. The mean age was 9.9 years. All patients had sudden onset profound vision loss (range 3/60 to hand movement). Four patients had bilateral involvement, all had reduced colour vision. Three had underlying acute disseminated encephalomyelitis. All were treated with high-dose intravenous corticosteroids. Five patients made full recovery, one patient had partial recovery, and one patient had no visual recovery. Interestingly, none of them had multiple sclerosis (MS) or neuromyelitis optica (NMO) at the time of diagnosis. Conclusion: Prognosis is generally good for isolated cases of paediatric optic neuritis. Outcome of cases secondary to ADEM depends on the degree and extent of demyelination. A diagnosis of chronic relapsing inflammatory optic neuropathy can be considered in recurrent cases that are steroid responsive. None of our cases had underlying MS or NMO during the study period.