RiskFactorsforIdiopathicOpticNeuritisRecurrenceYiDu.",Jing-JingLi.",Yu-JiaoZhang,KaijunLi,Jian-FengHe*DepartmentofOphthalmology,TheFirstAffiliatedHospitalofGuangxiMedicalUniversity,Nanning,Guangxi,ChinaAbstractBackground:Approximately30–50%ofidiopathicopticneuritis(ION)patientsexperienceoneormultipleepisodesofrecurrence.TheaimofthisstudywastosearchforriskfactorsforIONrecurrence.Methods:ClinicaldataonhospitalizedpatientsdiagnosedwithIONbetweenJanuary2003andJanuary2011attheFirstAffiliatedHospitalofGuangxiMedicalUniversitywereretrospectivelycollected.UnivariateandmultivariateanalyseswereperformedonfactorsthatmightcauseIONrecurrence.Intotal,115IONcases(32recurrentand83non-recurrentcases)withcompletedatawereanalyzed.Thelengthofthefollow-upperiodrangedfrom12to108months(median:42months).Results:TheunivariateanalysisshowedthattherecurrencerateforunilateralIONwashigherthanthatforbilateralION(40%vs.12%,p=0.001).Underlyingdiseaseshadasignificantimpactonrecurrence(p,0.001):therecurrenceratesduetoneuromyelitisoptica(NMO),multiplesclerosis(MS),demyelinatinglesionsaloneofthecentralnervoussystem,andunknowncauseswere89%,70%,41%,and8.7%,respectively.ThemultivariateanalysisshowedthatthefactorscausingrelativelyhighrecurrenceratesincludedNMO(oddsratio[OR],73.5;95%confidenceinterval[CI],7.3to740.9),MS(OR,33.9;95%CI,5.2to222.2),anddemyelinatinglesionsalone(OR,8.9;95%CI,2.3to34.4),unilateralinvolvement(OR,5.7;95%CI,1.5to21.3),relativelylowinitialglucocorticoiddosage(equivalentto#100mgprednisone/day)(OR,4.3;95%CI,1.0to17.9).Conclusion:Underlyingdiseases,laterality(unilateralorbilateral),andinitialglucocorticoiddosageareimportantriskfactorsofIONrecurrence.ClinicalphysiciansareadvisedtotreatIONpatientswithasufficientdoseofglucocorticoidintheinitialtreatmentstagetoreducetherecurrencerisk.Citation:DuY,LiJ-J,ZhangY-J,LiK,HeJ-F(2014)RiskFactorsforIdiopathicOpticNeuritisRecurrence.PLoSONE9(9):e108580.doi:10.1371/journal.pone.0108580Editor:PabloVilloslada,InstituteBiomedicalResearchAugustPiSunyer(IDIBAPS)-HospitalClinicofBarcelona,SpainReceivedMarch2,2014;AcceptedSeptember1,2014;PublishedSeptember25,2014Copyright:�2014Duetal.Thisisanopen-accessarticledistributedunderthetermsoftheCreativeCommonsAttributionLicense,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalauthorandsourcearecredited.Funding:ThisstudywassupportedbytheNationalNaturalScienceFoundationofChina(No.81260149,No.81360152).Website:http://www.nsfc.gov.cn/.Thefundershadnoroleinstudydesign,datacollectionandanalysis,decisiontopublish,orpreparationofthemanuscript.CompetingInterests:Theauthorshavedeclaredthatnocompetinginterestsexist.*Email:hejianf@foxmail.com.Theseauthorscontributedequallytothiswork."Theseauthorsarejointfirstauthorsonthiswork.IntroductionOpticneuritisisanacuteinflammatorydemyelinatingdiseaseoftheopticnerves[1,2].Itcanoccureitherindependentlyorasapartofmultiplesclerosis(MS)orneuromyelitisoptica(NMO).Whentherearenoothersystemicdiseases,thisdiseaseiscalledidiopathicopticneuritis(ION)[3].Accordingtoliterature,approximately30–50%ofIONpatientshaveatleastonerecurringattack[4].IntheUnitedStatesofAmerica,theOpticNeuritisTreatmentTrial(ONTT)foundthatunilateralIONpatientsreceivingoralprednisone(1mg/kg/day)facedanincreasedriskofnewepisodesofopticneuritis,whilepatientsreceivingintravenousmethylpred-nis...
