Eye 2001 Aug;15(Pt 4):469-73
Pokroy R, Modi G, Saffer D.
Department of Neurology, Baragwanath
Chris Hani Hospital, University of Witwatersrand, Johannesburg-Soweto,
South Africa.
PURPOSE:
To describe the clinical profile
of idiopathic optic neuritis in South African blacks.
METHODS:
South African black patients with
acute isolated idiopathic optic neuritis, treated and followed for at least
3 months at a large medical centre, were studied. Exclusion criteria were
other causes of optic neuropathy (such as ischaemic optic neuropathy, toxins
or Leber's hereditary optic neuropathy); all causes of optic neuritis (such
as HIV, neurosyphilis, sarcoid or connective tissue disease); neurological
disease outside of the optic nerves; and any race other than South African
black. Patients underwent extensive ophthalmic, neurological, radiological,
cerebrospinal fluid and blood assessment.
RESULTS:
Eighteen eyes of 10 patients were
studied. The mean age was 35.7 years and 9 patients were female. Only 2
patients had truly unilateral optic neuritis, the other 8 having either
bilaterally simultaneous or consecutive disease. Presenting visual acuity
(VA) was less than 6/60 in 17 of 18 eyes, with severe dyschromatopsia in
all eyes. Fifteen eyes had optic disc swelling. All patients were treated
with corticosteroids. After at least 3 months follow-up only 6 eyes recovered
VA of 6/12 or better, with only 3 eyes recovering colour vision of 10/13
or better on Ishihara plate testing. No patient had multiple sclerosis
(MS) on presentation, nor developed MS on follow-up.
CONCLUSION:
Idiopathic optic neuritis in black
South Africans differs from that in whites. The higher prevalence of bilateral
cases and of optic disc swelling, the weaker association with MS and the
extremely poor visual outcome distinguish optic neuritis in black South
Africans.
PMID: 11767021 [PubMed - indexed
for MEDLINE]