Authors:

Abstract

The clinical profile of optic neuritis in caucasian European populations is well-documented, and those findings form the basis for current treatment strategies. Limited evidence from Asian samples suggests a lower prevalence of multiple sclerosis and a significant proportion of patients having bilateral optic neuritis. This study describes the clinical characteristics of optic neuritis in Sri Lankans, a South Asian population, and compares the clinical picture with those of other Asian and caucasian European populations.

We consecutively recruited 90 adults (age 18-75 years, 50 women) who presented with first-episode optic neuritis to a tertiary care ophthalmology centre in Sri Lanka. The clinical and ophthalmological findings are described.

The patients presented within a median of 5 (Interquartile range, IQR:2-10; range: 1-20) days following the onset of symptoms. Fifty-three (59%) patients had unilateral optic neuritis, and 37 (41%) had bilateral optic neuritis. In the total sample, 60% had peri-ocular pain and 67% had optic disc oedema. In the subsample with unilateral optic neuritis, 58% had peri-ocular pain, while 80% had optic disc oedema.

Our findings indicate that a significant proportion of first-episode optic neuritis is bilateral: a presentation common in Asia but rare in people of Caucasian European descent. Unilateral optic neuritis in Sri Lankans has a different presentation compared to the caucasian European population: peri-ocular pain is less common, but almost 4 in 5 patients had optic disc oedema. The significance of these differences in the diagnosis and management of patients is yet to be investigated. 

Keywords: Optic neuritis, Asia, Unilateral, Bilateral, Clinical characteristics, Disc oedema, Peri-ocular pain