Early Retinal Changes Following Paediatric Optic Neuritis

Retinal nerve fiber layer (RNFL) and ganglion cell/inner plexiform layer (GCIPL) thinning occurs in the chronic phase following optic neuritis (ON) in children, but early changes have not been reported. This cross-sectional study evaluates children with ON as part of a first demyelinating event (n=33) using spectral-domain optical coherence tomography (OCT) performed within 30 days of onset. Comparison was made to healthy controls (n=33). GCIPL thickness was reduced in both ON-affected (-5.71um; p = 0.0013) and fellow eyes (-6.00um; p = 0.0013) compared to controls. Fewer ON-affected eyes in children with MS (3/10 eyes; 30%) demonstrated RNFL swelling above the 95th percentile of controls compared to those of other demyelinating disorders (29/37 eyes; 78.4%; p = 0.007). This suggests that early retinal injury occurs in paediatric ON, which may reflect pre-existing subclinical injury not directly related to clinical ON. Patterns of injury may differ in youth with MS.M.Sc