Cerebrospinal fluid in acute optic neuritis: experience of the optic neuritis treatment trial

L A Rolak; R W Beck; D W Paty; W W Tourtellotte; J N Whitaker; R A Rudick; Optic Neuritis Study Group

doi:10.1212/WNL.46.2.368

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Cerebrospinal fluid in acute optic neuritis: experience of the optic neuritis treatment trial

Journal article

Peer reviewed

Cerebrospinal fluid in acute optic neuritis: experience of the optic neuritis treatment trial

L A Rolak, R W Beck, D W Paty, W W Tourtellotte, J N Whitaker, R A Rudick and Optic Neuritis Study Group

Neurology, Vol.46(2), pp.368-372

02/1996

DOI: 10.1212/WNL.46.2.368

PMID: 8614496

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Abstract

The Optic Neuritis Treatment Trial (ONTT) is a prospective study of corticosteroid treatment of acute optic neuritis (ON), with subsequent longitudinal follow-up to determine development of clinically definite multiple sclerosis (CDMS). We analyzed the CSF of 83 patients with clinically isolated ON who underwent lumbar puncture within 24 hours of enrollment into the ONTT to determine the value of CSF changes in ON, especially regarding diagnostic utility, immunologic changes, MRI correlations, and progression to CDMS. All patients had baseline MRI scans graded for changes typical of MS. CSF measurements included immunoglobulin G (IgG) synthesis, IgG ratio, myelin basic protein, IgG kappa light chains, and oligoclonal banding. No patients had their diagnosis or management altered as a result of CSF findings. Except for oligoclonal bands, few patients showed any abnormalities on CSF tests, and no tests correlated with the 2-year development of CDMS. Oligoclonal banding, present at baseline in 11 of 13 patients who developed CDMS, did predict progression to CDMS, but this was not independent of MRI abnormalities. Two patients with oligoclonal bands and a normal MRI did progress to CDMS. We conclude that CSF analysis may not be necessary in the routine evaluation of patients presenting with a typical clinical profile of acute ON, and that most CSF tests add little additional information to MRI results for predicting the 2-year development of CDMS. However, the precise role of oligoclonal banding in the analysis of such patients awaits longer follow-up of this cohort.

Magnetic Resonance Imaging

Myelin Basic Protein - cerebrospinal fluid

Injections, Intravenous

Prednisolone - administration & dosage

Prospective Studies

Follow-Up Studies

Methylprednisolone - therapeutic use

Administration, Oral

Humans

Middle Aged

Immunoglobulin kappa-Chains - cerebrospinal fluid

Optic Neuritis - cerebrospinal fluid

Optic Neuritis - physiopathology

Immunoglobulin G - cerebrospinal fluid

Optic Neuritis - drug therapy

Adolescent

Adult

Prednisolone - therapeutic use

Longitudinal Studies

Methylprednisolone - administration & dosage

Details

Title: Subtitle: Cerebrospinal fluid in acute optic neuritis: experience of the optic neuritis treatment trial
Creators: L A Rolak - Multiple Sclerosis Center, The Marshfield Clinic, WI 54449, USA
R W Beck
D W Paty
W W Tourtellotte
J N Whitaker
R A Rudick
Optic Neuritis Study Group (Institution)
Resource Type: Journal article
Publication Details: Neurology, Vol.46(2), pp.368-372
Publisher: United States
DOI: 10.1212/WNL.46.2.368
PMID: 8614496
ISSN: 0028-3878
eISSN: 1526-632X
Language: English
Date published: 02/1996
Academic Unit: Ophthalmology and Visual Sciences
Record Identifier: 9983979930202771

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