To investigate the presence of an ethnicity bias within patients presenting with optic neuritis in London.
Observational cross-sectional study.
The ethnicity profile of all patients attending a neuro-ophthalmology clinic in central London with acute optic neuritis over a 16 month period (n=86) was studied. A comparison was made with the ethnicity profile of the population of London as well as patients with Multiple Sclerosis-associated optic neuritis (n=41), Neuromyelitis Optica spectrum disorder-associated optic neuritis (n=27) and patients with an atypical corticosteroid-dependent optic neuropathy (21).
The ethnicity profile of the patient cohort presenting to our clinic with acute optic neuritis over a 16 month period closely matched the ethnicity profile of London (P=0.08). Within this cohort, patients of African or African-Caribbean heritage were found to be more likely to manifest either a pattern or aetiology of optic neuritis requiring immunosuppressive treatment in comparison with patients of a white Caucasian background (relative risk 3.47; 95% CI=1.092 to 11.007). There was a disproportionately high representation of patients from an African or African-Caribbean background within the Neuromyelitis Optica spectrum-related optic neuritis diagnostic group (P<0.00).
Patients with acute isolated optic neuritis from African or African Caribbean backgrounds are over 3 times more likely than patients of white Caucasian backgrounds to have an ‘atypical’ pattern of optic neuritis where corticosteroid therapy may be required. Our results suggest that a patient's ethnic background is an important factor to be taken into consideration when deciding on the diagnosis and management of acute isolated optic neuritis.
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Published online: September 19, 2011
Accepted: August 22, 2011
Received in revised form: July 29, 2011
Received: July 4, 2011
© 2011 Elsevier B.V. Published by Elsevier Inc. All rights reserved.