Clinical Analysis Of The Factors Affecting The Recurrence Of Idiopathic Demyelinating Optic Neuritis

Objective:To explore the probable clinical factors affecting the recurrence of idiopathic demyelinating optic neuritis(IDON) and to provide the basement for the prevention of the recurrence.Methods:Retrospective medical record review of both clinical and labora-tory evidence supporting the diagnosis of IDON patients in Guangxi Medical University First Affiliated Hospital between January2003and January2011,and all cases had been followed-up before January2012.Univariate and multivariate analysis were used to analyze the probable clinical factors affecting the recur-rence.Results:115IDON patients were enrolled in the study.32patients were recurrent and83patients were not. Data from Univariate analysis showed that the age (P=0.453), best corrected visual acuity (BCVA) at first attack (P=0.962), gender(P=0.091), disc swelling(P=0.098), the treatment dosage of glucocorti-coid (P=0.128) and demyelination at first attack (P=0.082) were not associated with the risk of recurrence but the ON affected unilateral or bilateral (P=0.001) and the clinical outcome (P<0.001) were positively. Multivariate analysis sug-gested the clinical outcome, ON affected unilateral or bilateral, and the gluco-corticoid treatment dosage of IDON were the important factors of recurrence. The recurrence was higher in Demyelination (40.74%), multiple sclerosis (MS)70.00%and neuromyelitis optica (NMO)(88.89%) than that in unknown causes (8.70%)(P<0.001); the rate of recurrence in unilateral ON was40.00%, while12.00%in bilateral ON (P=0.009); The relapse rate in the gene effect dosage treatment group was significantly higher than that in the non-gene effect dosage treatment group (42.11%vs.25.00%, P=0.045).Conclusion:The clinical outcome, ON affected unilateral or bilateral, and the treatment dosage of glucocorticoid of IDON were the important causes of recurrence. It was necessary to give recurrent ON, which could be a strong predictor of MS and NMO. Appropriate popular science education should be performed and regular reexamination and followed-up should be paid attention to. The study also confirmed that the bilateral ON dif-fered from unilateral ON, and they should be investigated separately in the re-search.