Zapalenie nerwu wzrokowego
Epidemiologia
Zapalenie nerwu wzrokowego (ON) jest zapalnym schorzeniem nerwu wzrokowego, często powiązanym ze stwardnieniem rozsianym (SM) oraz innymi chorobami autoimmunologicznymi. Roczna zapadalność ON waha się od 0,56 do 8,1 przypadków na 100 000 osób, z wyższymi wartościami w USA (5-6,4/100 000) i wśród amerykańskich sił zbrojnych (8,1/100 000). Rozpowszechnienie wynosi od 5,5 do 115,3/100 000, z najnowszymi danymi z USA wskazującymi na 51,6/100 000 (2023). ON najczęściej dotyka młodych dorosłych (średnia wieku około 32 lata), z wyraźną przewagą kobiet (stosunek 2:1 do 5:1) oraz osób rasy kaukaskiej, choć w USA najwyższe rozpowszechnienie obserwuje się u osób rasy czarnej. Epidemiologia ON wykazuje silny związek geograficzny, z wyższą zapadalnością w klimacie umiarkowanym i na wyższych szerokościach geograficznych, co koreluje z rozkładem SM. Czynniki takie jak niedobór witaminy D i ekspozycja na słońce mogą wpływać na ryzyko rozwoju choroby.
- Epidemiologia zapalenia nerwu wzrokowego
- Zachorowalność na zapalenie nerwu wzrokowego
- Rozpowszechnienie zapalenia nerwu wzrokowego
- Rozkład demograficzny
- Rozkład geograficzny
- Zapalenie nerwu wzrokowego a stwardnienie rozsiane
- Zapalenie nerwu wzrokowego w różnych regionach świata
- Trendy w epidemiologii zapalenia nerwu wzrokowego
- Zapalenie nerwu wzrokowego u dzieci
- Nadzór nad zapaleniem nerwu wzrokowego
Epidemiologia zapalenia nerwu wzrokowego
Zapalenie nerwu wzrokowego (ang. optic neuritis, ON) jest zapalnym schorzeniem nerwu wzrokowego prowadzącym do zaburzeń widzenia, często powiązanym ze stwardnieniem rozsianym (SM) oraz innymi chorobami autoimmunologicznymi. Częstość występowania i charakterystyka demograficzna zapalenia nerwu wzrokowego różni się w zależności od położenia geograficznego, płci i grupy wiekowej.12
Zachorowalność na zapalenie nerwu wzrokowego
Roczna zapadalność na zapalenie nerwu wzrokowego waha się według różnych badań od 0,56 do 5,36 przypadków na 100 000 osób.13 W Stanach Zjednoczonych szacunki wskazują na około 5-6,4 przypadków na 100 000 mieszkańców rocznie.45 Wyższe wartości zapadalności odnotowano w badaniu amerykańskich sił zbrojnych, gdzie wskaźnik wyniósł 8,1 na 100 000 osób w latach 2006-2018.6 Natomiast w Finlandii Południowej zapadalność oszacowano na 3,0 przypadki na 100 000 osób.7 W badaniu przeprowadzonym w Wielkiej Brytanii na grupie 11 milionów osób stwierdzono zapadalność na poziomie 3,7 przypadku na 100 000 osobolat.89
Rozpowszechnienie zapalenia nerwu wzrokowego
Wskaźniki rozpowszechnienia zapalenia nerwu wzrokowego są rzadziej raportowane i wykazują znaczną zmienność, od 5,5 do 115,3 przypadków na 100 000 osób.10 Badanie przeprowadzone w hrabstwie Olmsted w stanie Minnesota (USA) w latach 1985-1991 wykazało rozpowszechnienie na poziomie 115,3 na 100 000 osób.10 Nowsze dane z USA z 2023 roku wskazują na rozpowszechnienie wynoszące 51,6 przypadków na 100 000 mieszkańców.310 Szacunkowe dożywotnie ryzyko wystąpienia zapalenia nerwu wzrokowego wynosi 0,6 na 1000 osób.11
Rozkład demograficzny
Wiek: Zapalenie nerwu wzrokowego najczęściej dotyka młodych dorosłych, zwykle w wieku między 20 a 50 rokiem życia, ze średnią wieku zachorowania wynoszącą około 32 lata.112 Typowe zapalenie nerwu wzrokowego rzadko występuje w populacji pediatrycznej, choć u dzieci może pojawić się obustronne zapalenie nerwu wzrokowego.1213 Atypowe zapalenie nerwu wzrokowego natomiast częściej dotyczy dzieci oraz osób powyżej 50 roku życia.1415
Płeć: Kobiety są znacznie częściej dotknięte zapaleniem nerwu wzrokowego niż mężczyźni, z proporcją od 2:1 do 3:1, a niektóre źródła podają nawet stosunek 5:1.11512 Ten wzorzec jest zgodny z rozkładem płci obserwowanym w stwardnieniu rozsianym, gdzie kobiety również nieproporcjonalnie częściej chorują. Wyższa zapadalność u kobiet może być związana z autoimmunologicznym charakterem choroby, ponieważ wiele zaburzeń autoimmunologicznych występuje częściej u kobiet.12
Etniczność: Zapalenie nerwu wzrokowego występuje częściej u osób rasy kaukaskiej niż w innych grupach etnicznych.116 Według niektórych badań osoby pochodzenia północnoeuropejskiego rozwijają zapalenie nerwu wzrokowego osiem razy częściej niż osoby rasy czarnej i Azjaci.5 Jednakże w populacjach azjatyckich i afrykańskich zapalenie nerwu wzrokowego może prezentować się inaczej i jest często związane z zaburzeniami takimi jak spektrum chorób neuromyelitis optica (NMOSD) niż ze stwardnieniem rozsianym.16 Nowsze dane z USA pokazują jednak, że najwyższe rozpowszechnienie zapalenia nerwu wzrokowego występuje wśród osób rasy czarnej, z podobnym wskaźnikiem wśród osób rasy białej, a najniższe rozpowszechnienie obserwuje się w populacji latynoskiej.10
Rozkład geograficzny
Zapadalność na zapalenie nerwu wzrokowego wykazuje wyraźny wzorzec geograficzny, który jest zgodny z rozkładem geograficznym stwardnienia rozsianego. Zapalenie nerwu wzrokowego jest częstsze w klimacie umiarkowanym i rzadsze w regionach położonych bliżej równika.116 Większa częstość występowania zapalenia nerwu wzrokowego obserwowana jest w populacjach zamieszkujących wyższe szerokości geograficzne, takie jak północne Stany Zjednoczone, Europa Zachodnia i Północna (np. Skandynawia, Wielka Brytania) oraz Kanada.4817
Niektóre badania wskazują, że osoby, które migrują przed okresem dojrzewania, przyjmują częstość występowania stwardnienia rozsianego charakterystyczną dla obszaru, do którego wyemigrowały. Sugeruje to możliwą interakcję między pochodzeniem etnicznym pacjenta, szerokością geograficzną i czynnikiem (lub czynnikami) wyzwalającymi stwardnienie rozsiane. Inne badania sugerują, że mniejsza ekspozycja na słońce na większych szerokościach geograficznych może być czynnikiem ryzyka stwardnienia rozsianego, a niedobór witaminy D jest dodatkowym potencjalnym wyjaśnieniem niektórych różnic epidemiologicznych w SM. Ponadto zaobserwowano zwiększoną zapadalność na zapalenie nerwu wzrokowego w okresie wiosennym.1819
Zapalenie nerwu wzrokowego a stwardnienie rozsiane
Zapalenie nerwu wzrokowego jest silnie związane ze stwardnieniem rozsianym (SM). Jest objawem początkowym SM u 15-20% pacjentów, a u 50% pacjentów z SM występuje w pewnym momencie przebiegu choroby.420 Badanie Optic Neuritis Treatment Trial (ONTT) wykazało, że u około 50% pacjentów z zapaleniem nerwu wzrokowego rozwinie się stwardnienie rozsiane w ciągu 15 lat od zachorowania.2122 Inne badanie wykazało, że ryzyko rozwoju SM wyniosło 54% po 30 latach.22
Obecność zmian demielinizacyjnych w istocie białej mózgu w badaniu MRI znacząco wpływa na ryzyko rozwoju SM. W badaniu ONTT ryzyko rozwoju SM w 15-letniej obserwacji wynosiło 25% dla pacjentów bez zmian w MRI i 75% dla pacjentów ze zmianami w istocie białej.2221 W badaniu przeprowadzonym w amerykańskich siłach zbrojnych ogólne 5-letnie ryzyko progresji do SM wyniosło 15%, a większość (68%) przypadków SM zdiagnozowano w ciągu 1 roku od diagnozy zapalenia nerwu wzrokowego. Ryzyko konwersji do SM u kobiet było znacząco wyższe niż u mężczyzn.6
Zapalenie nerwu wzrokowego w różnych regionach świata
| Region | Charakterystyka epidemiologiczna | Szczególne cechy |
|---|---|---|
| Stany Zjednoczone | Zapadalność: 5-6,4/100 000 rocznie Rozpowszechnienie: 51,6/100 000 (2023) |
Większa częstość występowania u osób rasy białej i czarnej w porównaniu do Latynosów |
| Europa Północna i Zachodnia | Zapadalność: 4-5/100 000 rocznie (Szwecja, Dania) Zapadalność: 3,7/100 000 osobolat (Wielka Brytania) |
Silna korelacja z występowaniem stwardnienia rozsianego |
| Azja | Proporcjonalnie częstsze w stosunku do częstości SM niż w USA czy Europie Zachodniej | Często związane z NMOSD zamiast SM |
| Indie | Zmiana epidemiologii – wzrost wykrywalności | Atypowe prezentacje i stosunkowo gorsze rokowanie 50% przypadków NMOSD ma przeciwciała AQP4 lub MOG |
| Tajlandia | Najczęstszą etiologią jest zapalenie idiopatyczne, następnie NMOSD | Ciężka utrata wzroku i wzmocnienie długiego odcinka nerwu wzrokowego to częste objawy |
| Afryka | Brak dużych prospektywnych badań kohortowych | Populacje afrykańskie zazwyczaj nie prezentują typowego zapalenia nerwu wzrokowego |
Trendy w epidemiologii zapalenia nerwu wzrokowego
Dane z USA wskazują, że rozpowszechnienie zapalenia nerwu wzrokowego wzrosło 1,08 razy w latach 2016-2023, przy czym największy wzrost zaobserwowano w populacji latynoskiej.3 W tym samym okresie w grupie wiekowej 0-14 lat odnotowano największy wzrost rozpowszechnienia, a następnie w grupie 15-24 lat. Ogólnie obserwuje się tendencję do większego wzrostu rozpowszechnienia w młodszych grupach wiekowych w porównaniu ze starszymi.10
W Indiach obserwuje się zmianę epidemiologii chorób demielinizacyjnych. Podczas gdy wcześniejsze badania indyjskie wykazywały, że SM stanowi od 0,32% do 1,58% przyjęć neurologicznych w szpitalach, a rozpowszechnienie wynosi około 1,33/100 000, nowsze badanie przeprowadzone w miejskim Mangalore wykazało rozpowszechnienie 8,3/100 000 dla SM i 2,6/100 000 dla chorób ze spektrum neuromyelitis optica (NMOSD). Ta zmiana epidemiologii może wynikać z większej świadomości choroby, lepszej dokumentacji oraz z rozwoju niskiego progu dla badań MRI wśród neurologów i okulistów.23
W badaniu przeprowadzonym w Wielkiej Brytanii obejmującym okres 22 lat (1995-2019) roczna zapadalność na zapalenie nerwu wzrokowego pozostawała względnie stabilna, między 3 a 4 przypadkami na 100 000 osobolat.27
Zapalenie nerwu wzrokowego u dzieci
Zapalenie nerwu wzrokowego u dzieci różni się od postaci występującej u dorosłych. Obustronne zapalenie nerwu wzrokowego w dzieciństwie nie jest rzadkie, a ryzyko progresji do SM jest uważane za niższe w dzieciństwie.213 Niemieckie badanie kohortowe pediatrycznych pacjentów z zapaleniem nerwu wzrokowego wykazało, że ryzyko rozwoju SM wynosiło ogólnie 42%, ale tylko 8% u pacjentów poniżej 11 roku życia. Najwyższe ryzyko rozwoju SM dotyczy pacjentek płci żeńskiej powyżej 10 roku życia i wynosi 68%. Poniżej tego wieku ryzyko było zredukowane do 8%.28
Prążki oligoklonalne w płynie mózgowo-rdzeniowym i zmiany w istocie białej w badaniu MRI okazały się wysoce istotnymi czynnikami ryzyka rozwoju SM (p<0,001).28 Warto zauważyć, że do 2021 roku nie zgłoszono przypadków zapalenia nerwu wzrokowego u dzieci z COVID-19, choć takie przypadki odnotowano u dorosłych.29
Nadzór nad zapaleniem nerwu wzrokowego
Ze względu na silny związek zapalenia nerwu wzrokowego ze stwardnieniem rozsianym, istotne znaczenie ma właściwy nadzór nad pacjentami z tym schorzeniem. Obserwacja medyczna typowego zapalenia nerwu wzrokowego obejmuje monitorowanie ostrości wzroku i badanie pola widzenia przy wystąpieniu choroby i okresowo po tym, a także skierowanie do specjalisty SM w celu monitorowania progresji lub postępowania w istniejącym SM.30
Międzynarodowe Konsorcjum Zapalenia Nerwu Wzrokowego (ICON) rozpoczyna globalne badanie mające na celu zbadanie krajobrazu epidemiologicznego zapalenia nerwu wzrokowego poza dominującymi narracjami. Badanie to ma na celu prezentację ankiety, podkreślając znaczenie wiedzy o podgrupach, takich jak zapalenie nerwu wzrokowego związane z przeciwciałami przeciwko MOG (MOG-ON) i przeciwciałami przeciwko AQP4 (AQP4-ON, określane również jako NMOSD i choroba Devica) w populacji afrykańskiej.31
W Stanach Zjednoczonych opracowano efektywne narzędzie do eksploracji bazy danych elektronicznej dokumentacji medycznej (EMR) w celu oszacowania obciążenia zapaleniem nerwu wzrokowego w armii amerykańskiej i konwersji do SM w oparciu o dynamiczną kohortę.6 Takie narzędzia mogą pomóc w lepszym monitorowaniu i zarządzaniu zapaleniem nerwu wzrokowego.
Warto podkreślić, że optyczna koherentna tomografia (OCT) może odgrywać znaczącą rolę w diagnostyce i monitorowaniu pacjentów ze stwardnieniem rozsianym. OCT umożliwia wykrycie ścieńczenia okołopapilarnej warstwy włókien nerwowych siatkówki (RNFL) oraz warstwy komórek zwojowych i wewnętrznej warstwy splotowatej (GCIPL) plamki, które obserwuje się u pacjentów z SM zarówno z zapaleniem nerwu wzrokowego, jak i bez niego.3233
Znaczenie nadzoru dla zdrowia publicznego
Nadzór nad zapaleniem nerwu wzrokowego ma kluczowe znaczenie dla zdrowia publicznego z kilku powodów:3435
- Wzrastająca liczba przypadków chorób demielinizacyjnych, takich jak stwardnienie rozsiane, gdzie układ odpornościowy błędnie atakuje osłonkę mielinową chroniącą nerw wzrokowy, jest głównym czynnikiem napędzającym rynek zapalenia nerwu wzrokowego.34
- Monitorowanie trendów epidemiologicznych pomaga w planowaniu opieki zdrowotnej i alokacji zasobów.
- Lepsze zrozumienie czynników ryzyka zapalenia nerwu wzrokowego może prowadzić do opracowania skuteczniejszych strategii profilaktyki i leczenia.
- Nadzór pomaga w identyfikacji różnic geograficznych, etnicznych i płciowych w rozpowszechnieniu zapalenia nerwu wzrokowego, co może prowadzić do bardziej ukierunkowanych interwencji.
Badanie z Południowej Afryki, pierwsze duże prospektywne badanie szpitalne dotyczące zapalenia nerwu wzrokowego w Afryce Południowej, ma na celu lepsze zrozumienie prezentacji, etiologii i wyników zapalenia nerwu wzrokowego w kontekście afrykańskim. Populacje afrykańskie zazwyczaj nie prezentują typowego zapalenia nerwu wzrokowego i nie przeprowadzono dużych badań w Afryce Subsaharyjskiej w celu ustalenia prezentacji, etiologii i wyników atypowego zapalenia nerwu wzrokowego.26
Warto zaznaczyć, że na Kubie w przeszłości wystąpiła epidemia zapalenia nerwu wzrokowego, która obecnie jest pod kontrolą. Badania nad jej przyczyną i nadzór epidemiologiczny są nadal prowadzone.36
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Materiały źródłowe
- #1 Optic Neuritis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK557853/
The annual incidence of new-onset optic neuritis has been reported to be between 0.56 and 5.1 cases per 100,000. Risk factors for this condition include age (20 to 40 years), sex (female: male = 2:1), and race (Caucasian). […] An increased incidence of multiple sclerosis in temperate climates has been proposed. Studies have identified that the northern United States and western Europe have more cases than equatorial regions. […] Optic neuritis is an inflammatory condition of the optic nerve that leads to visual impairment and is often associated with multiple sclerosis and systemic autoimmune conditions. The frequency and demographics of optic neuritis vary by geographical location, sex, and age group. […] Optic neuritis varies worldwide, with an estimated annual incidence of 1 to 5 cases per 100,000 individuals. However, the incidence may be higher in populations with a greater prevalence of multiple sclerosis, as optic neuritis is often a presenting feature of this demyelinating disease. […] Women are more commonly affected by optic neuritis than men, with a female-to-male ratio of approximately 3:1. This pattern is consistent with the gender distribution seen in multiple sclerosis, where women are also disproportionately affected. […] Optic neuritis most frequently affects young adults, typically between the ages of 20 and 50. The average age of onset is around 32. […] The incidence of optic neuritis correlates with the geographic distribution of multiple sclerosis. Optic neuritis is more common in temperate climates and less common in regions near the equator. […] Optic neuritis is more common in Caucasians than in other ethnic groups. However, in Asian and African populations, optic neuritis may present differently and is often associated with conditions such as NMOSD rather than multiple sclerosis.
- #2 Optic Neuritis | Treatment & Management | Point of Carehttps://www.statpearls.com/point-of-care/26245
The annual incidence of new-onset optic neuritis has been reported to be between 0.56 and 5.1 cases per 100,000. Risk factors for this condition include age (20 to 40 years), sex (female: male = 2:1), and race (Caucasian). Children infrequently develop bilateral optic neuritis, but childhood disease is not believed to foreshadow the development of multiple sclerosis. An increased incidence of multiple sclerosis in temperate climates has been proposed. Studies have identified that the northern United States and western Europe have more cases than equatorial regions. […] Optic neuritis is an inflammatory condition of the optic nerve that leads to visual impairment and is often associated with multiple sclerosis and systemic autoimmune conditions. The frequency and demographics of optic neuritis vary by geographical location, sex, and age group.
- #3 Prevalence of pediatric and adult optic neuritis in the United States from 2016 to 2023 | Eyehttps://www.nature.com/articles/s41433-025-03683-8
Data on the prevalence of optic neuritis (ON) is limited with reported rates between 5.5 and 115.3 per 100,000. The US data is even more limited with the largest study performed in a single county, finding a prevalence of 115.3. This study aims to fill the gap in US data on ON. […] In 2023, the prevalence of ON was 51.6 per 100,000 people in the overall population. […] The prevalence of ON increased 1.08 times from 2016 to 2023, with the greatest increase seen in the Hispanic population. […] Racial, ethnic and sex disparities are apparent in the distribution of ON, with Black individuals and females affected most often, and an increasing prevalence seen in the Hispanic population. […] Data regarding the incidence and prevalence of ON are limited. Incidence rates vary considerably, ranging from 0.56 to 5.36 per 100,000.
- #4 Optic neuritis: Pathophysiology, clinical features, and diagnosis – UpToDatehttps://www.uptodate.com/contents/optic-neuritis-pathophysiology-clinical-features-and-diagnosis/print
Optic neuritis is an inflammatory, demyelinating condition that causes acute, usually monocular, visual loss. It is highly associated with multiple sclerosis (MS). Optic neuritis is the presenting feature of MS in 15 to 20 percent of patients and occurs in 50 percent at some time during the course of their illness. […] Most cases of acute demyelinating optic neuritis occur in females (two-thirds) and typically develop in patients between the ages of 20 and 40 years. […] The incidence of optic neuritis is highest in populations located at higher latitudes, in the northern United States and western Europe, and is lowest in regions closer to the equator. In the United States, studies have estimated the annual incidence of optic neuritis to be as high as 6.4 per 100,000. In the United States, optic neuritis occurs more frequently in White compared with Black Americans. In Asia, optic neuritis is proportionately more common relative to the incidence of multiple sclerosis (MS) than in the United States or Western Europe.
- #5 ON | Optic Neuritis | Epidemiology | SRNAhttps://wearesrna.org/living-with-myelitis/disease-information/optic-neuritis/epidemiology/
ON is a rare condition. US studies estimate the annual incidence to be 6.4 per 100,000 in population. The occurrence of ON tends to be the highest in populations located in higher latitudes (in the northern US and Western Europe), and is the lowest in regions closer to the equator. ON is more common in women (predominance ratio of 3:1) and develops in most patients between the ages of 20 and 45. Additionally, ON typically occurs more frequently in Caucasians than African Americans. It has been reported that white people with northern European descent develop ON eight times more frequently than black and Asian people.
- #6 Incidence of Optic Neuritis and the Associated Risk of Multiple Sclerosis for Service Members of U.S. Armed Forces – PubMedhttps://pubmed.ncbi.nlm.nih.gov/34417807/
Optic neuritis (ON), an acute inflammation of the optic nerve resulting in eye pain and temporary vision loss, is one of the leading causes of vision-related hospital bed days in the U.S. Military and may be a harbinger of multiple sclerosis (MS). […] The overall incidence rate of ON was 8.1 per 100,000 from 2006 to 2018. […] Most (68%) of subsequent diagnoses of MS were made within 1 year after diagnosis of ON. […] The overall 5-year risk of progression to MS was 15% (11%-16% for 95% CI). […] The risk of conversion to MS in females was significantly higher than in males. […] We developed an efficient tool to explore the EMR database to estimate the burden of ON in the U.S. Military and the MS conversion based on a dynamic cohort.
- #7 Population-Based Incidence of Acute Idiopathic Optic Neuritis Estimated – Neurology Advisorhttps://www.neurologyadvisor.com/news/population-based-incidence-of-acute-idiopathic-optic-neuritis-estimated/
This population-based study sought to estimate the incidence of acute optic neuritis in Southern Finland between May 1, 2008, and April 14, 2012. […] The incidence of optic neuritis in Southern Finland was 3.0 (95% CI, 2.8 to 3.3) per 100,000 people (4.6 females and 1.4 males). […] Overall, the presence of demyelinating MRI lesions in patients with first optic neuritis predicted the development of MS.
- #8 Optic neuritis | Radiology Reference Article | Radiopaedia.orghttps://radiopaedia.org/articles/optic-neuritis?lang=us
In a study of 11 million people in the UK, optic neuritis (all causes) was found to have an incidence of 3.7 per 100000 person-years. 69% of the cohort were female, with an average age of 35 years, and 92% were „white” 8. […] As typical optic neuritis is seen in the setting of multiple sclerosis (MS), most patients tend to be young adults, with a predominance of women of 3:1. The incidence is highest in populations living at higher northern latitudes (e.g. Scandinavia, United Kingdom, Canada), again, following the epidemiology of multiple sclerosis 3. A third of optic neuritis cases are due to multiple sclerosis 8.
- #9 Optic neuritis | Radiology Reference Article | Radiopaedia.orghttps://radiopaedia.org/articles/optic-neuritis?embed_domain=external.radpair.com%252525252527%25252525255B0%25252525255Dfavicon.icoradiopaedia-icon-144.pngfavicon.icofavicon.icofavicon.ico&lang=us
In a study of 11 million people in the UK, optic neuritis (all causes) was found to have an incidence of 3.7 per 100000 person-years. 69% of the cohort were female, with an average age of 35 years, and 92% were „white” 8. […] As typical optic neuritis is seen in the setting of multiple sclerosis (MS), most patients tend to be young adults, with a predominance of women of 3:1. The incidence is highest in populations living at higher northern latitudes (e.g. Scandinavia, United Kingdom, Canada), again, following the epidemiology of multiple sclerosis 3. A third of optic neuritis cases are due to multiple sclerosis 8. […] These are risk factors for all causes of optic neuritis, although the commonality of multiple sclerosis as a cause skews the demographics towards those of multiple sclerosis 8: female sex, obesity, older reproductive age, tobacco smoking, living at higher latitudes, Caucasian ethnicity.
- #10 Prevalence of pediatric and adult optic neuritis in the United States from 2016 to 2023 | Eyehttps://www.nature.com/articles/s41433-025-03683-8
Prevalence rates are infrequently reported and are even less consistent, with observed rates spanning from 5.5 to 115.3 per 100,000 individuals. […] The foundational work by Rodriguez et al., carried out in Olmsted County, MN, reported a prevalence of 115.3 per 100,000 persons from 1985 to 1991. […] This study establishes a prevalence rate of ON in the US over the past eight years, as well as a stratification of the prevalence rates by sex, age, race and ethnicity, providing a more accurate and updated landscape of ON in the US. […] Our findings indicate a prevalence of ON in the US of 51.6 per 100,000 people in 2023. […] The highest prevalence was found in the Black population, with a similar rate in the White population, and the lowest prevalence seen in the Hispanic or Latino population. […] From 2016 to 2023, the 0-14 age group had the largest prevalence increase, followed by those 15-24. Overall, there is a trend of greater increases in prevalence in the younger age groups compared to the older age groups.
- #11 Optic neuritis: A South African hospital-based prospective study protocol | PLOS Onehttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0269514
Optic neuritis is a relatively common disease with an estimated lifetime risk of 0.6 per 1000; the estimated prevalence is 15 per 100 000/year. It occurs because of inflammation of the optic nerve from a variety of causes. The diagnosis of the disorder is established clinically and current literature is predominantly based on white patients from high-income countries. Optic neuritis presents differently in black patients compared to white patients. This study aims to assess the presentation and outcome of optic neuritis patients in a South African setting. […] The global annual incidence of unilateral ON is approximately 0.942.18 per 100 000. […] A South African retrospective study by Pokroy et al., has shown that black patients present differently compared to white patients. […] This study represents one of the few cohort studies in Sub-Saharan Africa that seeks to investigate optic neuritis. Our hope is that it will lead to better insights regarding the presentation, course and outcome of this condition.
- #12 Optic Neuritis | Treatment & Management | Point of Carehttps://www.statpearls.com/point-of-care/26245
Incidence: Optic neuritis varies worldwide, with an estimated annual incidence of 1 to 5 cases per 100,000 individuals. However, the incidence may be higher in populations with a greater prevalence of multiple sclerosis, as optic neuritis is often a presenting feature of this demyelinating disease. […] Sex distribution: Women are more commonly affected by optic neuritis than men, with a female-to-male ratio of approximately 3:1. This pattern is consistent with the gender distribution seen in multiple sclerosis, where women are also disproportionately affected. The higher incidence in women is thought to be related to the autoimmune nature of the disease, as many autoimmune disorders are more prevalent in female individuals. […] Age distribution: Optic neuritis most frequently affects young adults, typically between the ages of 20 and 50. The average age of onset is around 32. While optic neuritis can occur in children or older adults, it is far less common in these age groups. In pediatric cases, optic neuritis may be more often associated with postinfectious and postvaccination syndromes rather than multiple sclerosis.
- #13 Adult Optic Neuritis: Practice Essentials, Background, Etiologyhttps://emedicine.medscape.com/article/1217083-overview
Optic neuritis (ON) is a demyelinating inflammation of the optic nerve that typically first occurs in young adulthood. Many cases of ON are associated with multiple sclerosis (MS) or neuromyelitis optica (NMO), but ON can occur in isolation. […] Investigators in Sweden and Denmark have reported an annual incidence of 4 to 5 cases of new-onset optic neuritis (ON) per 100,000 persons. Patients living in temperate climates seem to be predisposed to ON. […] Optic neuritis (ON) appears to affect White individuals more commonly than members of other races. Women are affected twice as often as men. […] Typically, patients with first-time, acute ON are young adults 20 to 45 years. Atypical cases of ON may be seen in elderly patients. Bilateral ON in childhood is not uncommon, and it is believed that the risk for progression to MS is lower in childhood.
- #14 Optic Neuritis: A Brief Reviewhttps://www.uspharmacist.com/article/optic-neuritis-a-brief-review
Geographically, typical ON occurs more frequently among populations dwelling in regions of higher latitude than among those who reside close to the equator. The incidence of typical ON is believed to be lower in Asian countries than in the United States. The incidence of atypical ON is dependent on disease etiology. In general, atypical ON is less prevalent in regions where typical ON is prominent. […] The risk factors for typical and atypical ON include age, gender, ethnicity, and genetic factors. Typical ON is highly prevalent among those 20 to 55 years of age, and is usually unilateral. However, it is rare in the pediatric population. Typical ON is more prevalent in women than men. Some studies have shown that prevalence among Caucasians is higher than that among Blacks. Finally, some genetic mutations increase the risk of typical ON. In contrast to typical ON, atypical ON is highly prevalent in pediatric patients and adults over 50 years of age, as well as Black, Asian, and Polynesian populations.
- #15 Diagnostic Approach to Atypical Optic Neuritis – EyeWikihttps://eyewiki.org/Diagnostic_Approach_to_Atypical_Optic_Neuritis
Typical demyelinating or idiopathic ON commonly affects young white women, with a reported female-to-male ratio of 5:1, and an age range of 20-40 years old. […] In the United States of America, studies have estimated the annual incidence of ON as 5 per 100,000. […] Atypical ON deviates away from this demographic and often includes males, with onset at age less than 18 or greater than 50 years old.
- #16 Optic Neuritis | Treatment & Management | Point of Carehttps://www.statpearls.com/point-of-care/26245
Geographic variations: The incidence of optic neuritis correlates with the geographic distribution of multiple sclerosis. Optic neuritis is more common in temperate climates and less common in regions near the equator. For instance, individuals of northern European descent tend to have a higher risk of developing optic neuritis, which mirrors the geographical prevalence patterns of multiple sclerosis. […] Ethnicity: Optic neuritis is more common in Caucasians than in other ethnic groups. However, in Asian and African populations, optic neuritis may present differently and is often associated with conditions such as NMOSD rather than multiple sclerosis.
- #17 Optic neuritis | Eyehttps://www.nature.com/articles/eye201181
The incidence of ON is highest in populations located at higher latitudes (eg, Northern United States; Northern and Western Europe; New Zealand and Southern Australia) compared with geographic locations closer to the equator. In the United States of America, studies have estimated the annual incidence of ON as 5 to 6.4 per 100000, with a prevalence of 115 per 100000. The demographics for ON would be expected to closely follow those seen in MS, although there is no data to support this known to the authors. ON is seen more commonly in Caucasians, and is uncommon but reported in black populations. Whites of Northern European descent develop ON eight times more frequently than blacks and Asians. In Asia, ON is proportionately more common relative to the incidence of MS in the United States of America or Western Europe. ON is less frequent in South America and in the Mediterranean region but newer studies have reported an increasing prevalence in the last few decades.
- #18 Optic neuritis | Eyehttps://www.nature.com/articles/eye201181
Some studies have shown that individuals who migrate before puberty have the incidence of MS in the area to which they have migrated. This suggests a possible interaction between the ethnic origin of the patient, the latitude, and whatever is the factor (or factors) that triggers MS. Other studies have suggested that less sun exposure at increasing latitude might be a risk factor for MS, and vitamin D deficiency is an additional potential explanation for some of the epidemiological differences in MS. In addition, an increased incidence of ON during the spring season has been reported. There are also some who postulate viruses as having a role in the pathogenesis of MS.
- #19 Optic neuritis | MedLink Neurologyhttps://www.medlink.com/articles/optic-neuritis
In a critical review of all epidemiological studies of optic neuritis before 1985, the incidence was approximately 3 in 100,000 people in northern latitudes where multiple sclerosis is common (northern United States, Western Europe), and fell to 1 in 100,000 in medium-risk areas for multiple sclerosis (Hawaii, Israel). […] The risk of developing optic neuritis increases with female sex, obesity, smoking, white, and residence at high latitudes. […] Episodes of optic neuritis are more common in the United States and Great Britain during spring and summer, and in Sweden during the spring. […] The maximum frequency of monosymptomatic optic neuritis is twice as high in the spring as in the fall, possibly an influence of virus infections or loss of sun exposure and vitamin D. […] The age in optic neuritis shows more patients at the young and old ends of the spectrum than in multiple sclerosis.
- #20 Optic neuritis: from one medical student to another medical studenthttps://webeye.ophth.uiowa.edu/eyeforum/tutorials/Optic-Neuritis/index.htm
Optic neuritis is the inflammation of the optic nerve. It can occur secondary to autoimmune, infectious, or inflammatory disorders and is strongly associated with multiple sclerosis (MS). It is the presenting symptom in 15-20% of cases of MS, but frequently occurs in the absence of MS. […] In addition, 65% of patients with multiple sclerosis will suffer from optic neuritis at some point during the course of the disease. […] It has an estimated annual occurrence rate of 5.1/100,00 in the United States, and is more commonly seen in women than in men. […] Much of the information regarding the natural history of optic neuritis, its treatment, and its relationship with multiple sclerosis has been acquired from the Optic Neuritis Treatment Trial (ONTT). This was a large clinical trial that followed optic neuritis patients over time which allowed for evaluation of the natural history of the disease and response to corticosteroid treatment.
- #21 Optic neuritis: from one medical student to another medical studenthttps://webeye.ophth.uiowa.edu/eyeforum/tutorials/Optic-Neuritis/index.htm
The ONNT showed that up to 50% of patients with optic neuritis will go on to develop multiple sclerosis. This trial also demonstrated that in patients with white matter lesions on MRI around 72% eventually developed multiple sclerosis versus only 25% of those with no white matter lesions, thus giving MRI an important role in determining risk of MS development. […] At the University of Iowa, we typically treat most cases of optic neuritis according to ONTT with a course of IV corticosteroids followed by oral prednisone. If there are white matter lesions on MRI at presentation, we refer the patient to neurology for continued surveillance for possible MS.
- #22 Optic Neuritis treated at Neurology Network Melbournehttps://neurologynetwork.com.au/neuro-ophthalmology/optic-neuritis/
Acute demyelinating optic neuritis demographics closely follow those of multiple sclerosis (MS), which has a higher frequency in Caucasian populations and at higher latitudes. Children who migrate before puberty take on the MS incidence of the area to which they migrate. […] Annual incidence of acute demyelinating optic neuritis is approximately 5/100,000; prevalence is 115 per 100,000. […] acute demyelinating optic neuritis is associated with MS. […] In the Optic Neuritis Treatment Trial, for adults with a single episode of unilateral acute demyelinating optic neuritis, the risk of MS was 38% at 10 years after onset, and 50% at 15 years. Another study found the MS risk was 54% after 30 years. The risk of developing MS is lower for children and for men. […] MRI of the brain gives information about the risk of developing MS. The presence of white matter abnormalities increases the MS risk and their absence reduces it. In the Optic Neuritis Treatment Trial, the risk of developing MS at 15-year follow-up was 25% for patients with no lesions on MRI, and 75% for those with white matter lesion(s).
- #23https://journals.lww.com/ijo/fulltext/2021/09000/approach_to_optic_neuritis__an_update.7.aspx
Demyelinating diseases were once considered rare in India with previous Indian studies showing that MS constitutes 0.32% to 1.58% of neurology admissions in hospitals, and a prevalence of approximately 1.33/100,000. […] However, a more recent population-based survey conducted in urban Mangalore has shown a prevalence of 8.3/100,000 for MS and 2.6/100,000 for neuromyelitis optic spectrum diseases (NMOSD). […] This change in epidemiology could be because of greater awareness about the disease, better documentation, and also due to the development of low threshold for MRI among neurologists and ophthalmologists. […] ON in India has been reported to be different from the West in terms of clinical features and prognosis. […] A substantial number of cases from this part of the world have been reported to have atypical presentations and relatively poorer prognosis.
- #24https://journals.lww.com/ijo/fulltext/2021/09000/approach_to_optic_neuritis__an_update.7.aspx
Recently published data from India suggests that 50% of NMOSD either have aquaporin4 (AQP4) or myelin oligodendrocytes (MOG) antibodies. […] Similarly, the seropositivity of Anti-MOG+ cases was 20% for AQP4 seronegative cases in the study. […] The common presentation of anti-AQP4+ was relapsing myelitis and ON with poor outcomes. […] The clinical picture of MOG in terms of recurrent ON and myelitis with a good response to steroid has been reported to be similar to that of western literature.
- #25 Etiologies of Acute Optic Neuritis in Thailand: An Observational Study | OPTHhttps://www.dovepress.com/etiologies-of-acute-optic-neuritis-in-thailand-an-observational-study–peer-reviewed-fulltext-article-OPTH
The most common etiology of acute ON at a university hospital in Bangkok, Thailand, was idiopathic, followed by NMOSD, other autoimmune disorders, MOGAD, MS, and postinfection. Severe visual loss and enhancement of the long segment of the optic nerve were frequent findings. […] The study highlighted the important role of antibodies in creating effective treatments in the future.
- #26 Optic neuritis: A South African hospital-based prospective study protocol | PLOS Onehttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0269514
To our knowledge there have been no large prospective cohort studies in a South African population on ON in terms of its clinical presentation, aetiology, treatment response and the effect or relevance of concomitant HIV infection. […] This study is the first large hospital based prospective study to be conducted on ON in Southern Africa. African populations do not usually present with T-ON and no large studies have been conducted in Sub-Saharan Africa to ascertain the presentation, aetiology and outcomes of A-ON. This is a first important step to understanding the presentation and outcomes of patients presenting with ON in an African context.
- #27 Optic Neuritis Incidence, Prevalence, Risks, and Etiologieslogo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-bhttps://www.jwatch.org/na53006/2021/01/05/optic-neuritis-incidence-prevalence-risks-and-etiologies
In a two-decade U.K. study, the differential was broad, with multiple sclerosis most common but a majority lacking MS. […] Investigators used a U.K. National Health Service database to evaluate 22-year trends in ON. Patients for this case-control and matched-cohort study presented between 1995 and 2019. […] Annual incidence of ON remained relatively stable, between 3 and 4 per 100,000 person-years. […] This study reports a number of important points. While MS is the most common cause of optic neuritis, the diagnosis is broad and includes inflammatory, infectious, and neoplastic etiologies.
- #28https://link.springer.com/article/10.1007/s00417-020-04669-w
Analysis of a cohort of pediatric optic neuritis patients concerning the epidemiology, disease progression, and association with multiple sclerosis (MS). […] During the observation period, the risk of developing MS was overall 42% and 8% for patients younger than 11 years. […] The percentage of MS as underlying cause of optic neuritis does not differ remarkably between children older 10 years and adults. […] The diagnosis of MS was made by neuropediatricians in accordance with the respectively applicable Mc Donald Criteria and MS-guideline of the German Society of Neurology in 42% of the patients during the study period. […] Oligoclonal bands and white matter lesions proved to be highly significant risk factors for the development of MS (p<0.001). [...] The highest risk of developing MS affects female patients older than 10 years and stands at 68%. Below that age, the risk was reduced to 8%. [...] The percentage of MS as underlying cause of optic neuritis does not differ remarkably between children and adults. Only in children younger than 11 years the MS risk seems to be lower.
- #29 Binocular Optic Neuritis in an Eight-Year-Old Boy Due to COVID-19 Infectionhttps://brieflands.com/articles/ijp-111798.html
Optic neuritis or inflammation of the optic nerve is a frequent cause of acute optic nerve damage in children and adults. […] However, to date, no case of optic neuritis has been reported in children with COVID-19. […] No case of optic neuritis has been reported in children with COVID-19. […] However, to date, there is no report of optic neuritis in the pediatric population, and our case can be the first report in this regard.
- #30 Optic Neuritis: A Brief Reviewhttps://www.uspharmacist.com/article/optic-neuritis-a-brief-review
Medical follow-up for typical ON includes visual acuity monitoring and visual field testing upon onset and periodically thereafter, as well as referral to an MS specialist to monitor for progression to, or management of, existing MS. In 15% to 20% of patients, ON is the initial symptom of MS, and 50% of MS patients will experience an episode of ON at some time during the course of their disease. […] Typical ON is associated with MS, and corticosteroid therapy may benefit selected patients short term. Therapeutic intervention with DMDs may prevent occurrence of a first MS attack or delay progression to a recurrent episode in existing MS. The etiology of atypical ON varies widely and dictates treatment options. NMO, an autoimmune disorder, is often linked to poor patient outcomes, with over 50% of patients becoming blind or wheelchair bound after 5 years.
- #31https://discovery.ucl.ac.uk/id/eprint/10187774/
The epidemiology of optic neuritis. […] Optic neuritis (ON) is a multifaceted condition with diverse epidemiological manifestations worldwide. The predominant literature has been influenced by a bias towards multiple sclerosis optic neuritis in predominantly Caucasian populations. This has resulted in an insufficient understanding of the heterogeneity within diverse ethnic groups. To address this gap, the International Consortium of Optic Neuritis (ICON) is launching a global survey to explore the epidemiological landscape of ON beyond the prevailing narratives. This talk aims to present the survey, emphasising the significance of learning about subgroups such as MOG-ON and AQP4-ON (also referred to as NMOSD and Devic disease) in the African population. Participants are encouraged to share their experiences through the survey, fostering a comprehensive understanding of ON across varied populations. Participants are invited to join the conversation and contribute to expanding our joint knowledge.
- #32 Multiple Sclerosis – EyeWikihttps://eyewiki.org/Multiple_Sclerosis
MS affects an estimated 400,000 people in the United States and 2.1 million people worldwide, with a more prevalent geographic distribution among the northern and southern hemispheres. The average age of onset ranges from 15 to 45 years while the average age at diagnosis is 30 years. Females are more commonly affected than males, at a ratio of about 2 to 1. […] Ocular manifestations are common in MS. Up to 20% of patients have optic neuritis as the initial clinical presentation and 75% of patients have at least one episode throughout the course of their lives. […] Optic neuritis in MS is typically seen as a unilateral T2 lesion of the optic nerve. Optical coherence tomography can aid in diagnosis of optic neuritis and MS and monitor progression. Thinning of the peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell layer and inner plexiform layer (GCIPL) are observed in MS patients both with and without optic neuritis.
- #33 Optic Neuritis: Update on Diagnosis, Management, and Long-term Follow-uphttps://practicalneurology.com/articles/2009-oct/PN1009_02-php
Optic neuritis is the presenting symptom in a sizable proportion (15-20 percent) of patients ultimately diagnosed with clinically definite MS. […] Given the association of ON with progression to MS in certain patients, efforts are underway to improve the long-term monitoring of patients at high risk for developing MS and to identify treatments that will yield the greatest benefit for all patients with ON. […] As research progresses and more studies are published, OCT may establish a significant role in the diagnosis and monitoring of patients with MS. […] In terms of possible neuroprotection, there is some evidence that glatiramer acetate (GA) may be neuroprotective, as it has been shown to help repair laser-induced retinal damage in rats. […] Among patients with abnormalities evident on the MRI, however, the risk of progression to MS is about 60 percent. […] Recurrent attacks of optic neuritis or chronic ON indicate a need to reconsider the diagnosis to rule out neuromyelitis optica or another diagnosis other than MS that may be present.
- #34 Optic Neuritis Market Size, Share, Trends & Forecast, 2034https://www.imarcgroup.com/optic-neuritis-market
The optic neuritis market has been comprehensively analyzed in IMARC’s new report titled „Optic Neuritis Market: Epidemiology, Industry Trends, Share, Size, Growth, Opportunity, and Forecast 2024-2034”. […] The increasing cases of demyelinating disorders like multiple sclerosis, where the immune system erroneously attacks the protective myelin sheath covering the optic nerve, are primarily driving the optic neuritis market. […] IMARC Group’s new report provides an exhaustive analysis of the optic neuritis market in the United States, EU5 (Germany, Spain, Italy, France, and United Kingdom) and Japan. This includes treatment practices, in-market, and pipeline drugs, share of individual therapies, market performance across the seven major markets, market performance of key companies and their drugs, etc.
- #35 Optic Neuritis Market Size, Share, Trends & Forecast, 2034https://www.imarcgroup.com/optic-neuritis-market
According to the report the United States has the largest patient pool for optic neuritis and also represents the largest market for its treatment. […] Historical, current, and future epidemiology scenario […] What is the number of prevalent cases (2018-2034) of optic neuritis across the seven major markets? […] What is the size of the optic neuritis patient pool (2018-2023) across the seven major markets? […] What would be the forecasted patient pool (2024-2034) across the seven major markets? […] What are the key factors driving the epidemiological trend of optic neuritis? […] What will be the growth rate of patients across the seven major markets?
- #36 Optic neuritis – ProQuesthttps://www.proquest.com/scholarly-journals/optic-neuritis/docview/198961760/se-2
The optic neuritis epidemic in Cuba, which is now under control, is discussed. Research into its cause and epidemiological surveillance are still being conducted.