Abstract
Purpose
To investigate the presence of an ethnicity bias within patients presenting with optic
neuritis in London.
Design
Observational cross-sectional study.
Methods
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).
Results
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).
Conclusions
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.
Keywords
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References
- Multiple sclerosis in KwaZulu Natal, South Africa: an epidemiological and clinical study.Mult Scler. Nov 2007; 13: 1095-1099
- Multiple sclerosis in black children.J Child Neurol. Jan 1991; 6: 53-57
- Neuromyelitis optica and opticospinal multiple sclerosis: mechanisms and pathogenesis.Pathophysiology. Feb 2011; 18: 69-79
- A population-based study of neuromyelitis optica in Caucasians.Neurology. May 3 2011; 76: 1589-1595
- Descriptive epidemiology of neuromyelitis optica in the Caribbean basin.Rev Neurol (Paris). Aug-Sep 2009; 165: 676-683
- An epidemiological study of neuromyelitis optica in Cuba.J Neurol. Jan 2009; 256: 35-44
- The spectrum of neuromyelitis optica.Lancet Neurol. 2007; 6: 805-815
- The 5-year risk of MS after optic neuritis. Experience of the optic neuritis treatment trial. Optic Neuritis Study Group.Neurology. Nov 1997; 49: 1404-1413
- A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis.Lancet. Dec 11–17 2004; 364: 2106-2112
- Revised diagnostic criteria for neuromyelitis optica.Neurology. 2006; 66: 1485-1489
- Early high-dose intravenous methylprednisolone is effective in preserving retinal nerve fiber layer thickness in patients with neuromyelitis optica.Graefes Arch Clin Exp Ophthalmol. Dec 2010; 248: 1777-1785
London: Resident population estimates by ethnic group. Office for National Statistics Neighbourhood Statistics. http://neighbourhood.statistics.gov.uk. Retrieved Aug 2009.
- Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria.Ann Neurol. Feb 2011; 69: 292-302
- Autoimmune optic neuropathy: evaluation and treatment.J Neurol Neurosurg Psychiatry. Nov 1988; 51: 1381-1386
- Erratum.in: J Neurol Neurosurg Psychiatry. 52(5). May 1989: 692
- Chronic relapsing inflammatory optic neuropathy (CRION).Brain. Feb 2003; 126: 276-284
- Aquaporin-4 antibodies in neuromyelitis optica and longitudinally extensive transverse myelitis.Arch Neurol. Jul 2008; 65: 913-919
- Different HLA class II (DRB1 and DQB1) alleles determine either susceptibility or resistance to NMO and multiple sclerosis among the French Afro-Caribbean population.Mult Scler. Jan 2011; 17: 24-31
- Neuromyelitis optica-IgG (aquaporin-4) autoantibodies in immune mediated optic neuritis.J Neurol Neurosurg Psychiatry. Jan 2010; 81: 109-111
- Ethnic change and diversity in England, 1981–2001.Area. 2004; 36.2: 174-186
- Optic neuritis in African Americans.Arch Neurol. Feb 1998; 55: 186-192
- Optic neuritis treatment trial. One-year follow-up results.Arch Ophthalmol. Jun 1993; 111: 773-775
- Evaluation of the management of optic neuritis: audit on the neurological and ophthalmological practice in the north west of England.J Neurol Neurosurg Psychiatry. Jan 2002; 72: 119-121
- IFNβ-1b may severely exacerbate Japanese optic-spinal MS in neuromyelitis optica spectrum.Neurology. Oct 19 2010; 75: 1423-1427
Article info
Publication history
Published online: September 19, 2011
Accepted:
August 22,
2011
Received in revised form:
July 29,
2011
Received:
July 4,
2011
Identification
Copyright
© 2011 Elsevier B.V. Published by Elsevier Inc. All rights reserved.