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Differential diagnoses to MS: experiences from an optic neuritis clinic

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Abstract

Optic neuritis (ON) is closely linked to multiple sclerosis (MS). It may, however, also be associated to a range of autoimmune or infectious diseases. The purpose of this study was to assess the differential diagnoses in patients with suspected ON. In this retrospective study, we reviewed the files of all patients referred to the Clinic of Optic Neuritis, Glostrup Hospital, University of Copenhagen, Denmark, between January 2000 and November 2011. All patients were referred by ophthalmologists with possible ON. Patients diagnosed with MS prior to referral were excluded from the study. A total of 643 patients were included in the study. Apart from ON, the most frequent diagnoses were tumors (n = 15), ischemic or hypertensive neuropathies (n = 13), and retinal or choroid disorders (n = 9). Six patients were diagnosed with neuromyelitis optica. Rarer causes of visual loss were infections (n = 5), giant cell arteritis (n = 4), sarcoidosis (n = 3), thyrotoxicosis (n = 2), and hereditary or toxic neuropathies (n = 2). Nine percent of patients referred to the Clinic of Optic Neuritis had symptoms caused by medical, neurosurgical or ophthalmic disorders, and 0.9 % of our patients had NMO. Though most of these conditions are rare, it is of importance to keep them in mind upon encountering patients with symptoms of ON.

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Acknowledgments

Anja Francis Madsen, Ali Wafik Awade, Bente Fabild and Jytte Horne Pedersen are thanked for excellent technical assistance. This study was funded by: The A.P. Møller and Hustru Chastine Mc-Kinney Møller Foundation. Fabrikant Einar Willumsen Foundation. Aase og Ejnar Danielsen Foundation. The Danish Multiple Sclerosis Foundation.

Conflicts of interest

Henrik Horwitz: Nothing to disclose. Tina Friis: Nothing to disclose. Signe Modvig: Nothing to disclose. Hanne Roed: Nothing to disclose. Anna Tsakiri: Nothing to disclose. Bjarne Laursen: Nothing to disclose. Jette Lautrup Frederiksen has served on scientific advisory boards for and received funding for travel related to these activities and honoraria from Biogen Idec, Sanofi-Aventis, Genzyme, Teva, Novartis and Almirall. Jette Frederiksen has received speaker honoraria from Biogen Idec, Merck Serono and Teva. She has served as advisor on preclinical development for Takeda.

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Authors and Affiliations

  1. Clinic of Optic Neuritis, Glostrup Hospital, University of Copenhagen, 2600, Glostrup, Copenhagen, Denmark

    Henrik Horwitz & Signe Modvig

  2. Pile Alle 5b st. tv., 2000, Frederiksberg, Denmark

    Henrik Horwitz

  3. Department of Clinical Biochemistry, Immunology and Genetics, Statens Serum Institut, Copenhagen, Denmark

    Tina Friis

  4. Department of Ophthalmology, Næstved Sygehus, Naestved, Denmark

    Hanne Roed

  5. Department of Neurology, Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark

    Anna Tsakiri & Jette Lautrup Frederiksen

  6. Statens Institut for Folkesundhed, University of Southern Denmark, Odense, Denmark

    Bjarne Laursen

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  1. Henrik Horwitz
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Correspondence to Henrik Horwitz.

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Horwitz, H., Friis, T., Modvig, S. et al. Differential diagnoses to MS: experiences from an optic neuritis clinic. J Neurol 261, 98–105 (2014). https://doi.org/10.1007/s00415-013-7166-x

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  • DOI: https://doi.org/10.1007/s00415-013-7166-x

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