Journal of Neurology

, Volume 262, Issue 7, pp 1646–1654 | Cite as

25-Hydroxyvitamin D levels in acute monosymptomatic optic neuritis: relation to clinical severity, paraclinical findings and risk of multiple sclerosis

  • Gorm Pihl-JensenEmail author
  • Jette Lautrup Frederiksen
Original Communication


Optic neuritis (ON) is a common first symptom of MS and only few studies have thus far investigated vitamin D at this early stage of MS. The objectives of the study were to examine total 25-hydroxyvitamin D levels (25HVITDL) in patients in acute (A) ON and to determine whether 25HVITD levels in AON (1) predict risk of RRMS and (2) are associated with visual tests of ON severity. A cross-sectional study was conducted of mean 25HVITDL differences between ON (n = 164) and MS (n = 948) patients and of prevalence of 25HVITDL deficiency (<50 nmol/L) in ON and MS (two-sample t test, χ 2 test). Associations between 25HVITDL and (1) clinical ON severity, (2) paraclinical findings suggestive of MS [logistic regression (LRA), Spearman correlation] and (3) hazard of MS development [Cox (C) RA] in ON patients were assessed. 25HVITDL were deseasonalized before analysis. The mean levels were 47.6 (ON) and 63.9 (MS) nmol/L (p < 0.0001), and a significantly higher prevalence of 25HVITD deficiency in ON (56 %; 35 %) (p < 0.0001), most pronounced in females, was shown. Associations were found between 25HVITDL and both CSF leukocyte count (ρ = −0.177, p = 0.028) and IgG index elevation (OR 0.980, p = 0.031). Forty-one ON patients developed MS during the study. Multivariate CRA showed no effect on hazard of MS (HR: 0.991, p 0.284). No association was found between 25HVITDL and visual tests (acuity, contrast vision) or OCT RNFL or GCL thickness. The study indicates a high prevalence of 25HVITD deficiency in AON. 25HVITDL was significantly associated with CSF leukocyte count, but not ON severity. The study indicates a possible role of vitamin D in the early stages of MS, but does not support the use of 25HVITDL as a predictor of MS development in acute ON.


Multiple sclerosis Optic neuritis Clinically isolated syndrome Vitamin D 


Conflicts of interest

Dr. Pihl-Jensen reports no disclosures. Dr. Frederiksen has served on a scientific advisory board and received funding for travel related to these activities and honoraria from Biogen Idec, Merck Serono, Teva Pharmaceutical Industries Ltd., Sanofi-Aventis, Novartis, Genzyme 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.

Ethical standard

The study was approved by the Danish Health and Medicines Authority and the Danish Data Protection Agency. Due to the retrospective study design, approval from research ethics committee was not required.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Gorm Pihl-Jensen
    • 1
    • 2
    Email author
  • Jette Lautrup Frederiksen
    • 1
    • 2
  1. 1.Clinic of Optic Neuritis, Department of NeurologyGlostrup Hospital, University of CopenhagenGlostrupDenmark
  2. 2.Clinic of Multiple Sclerosis, Department of NeurologyGlostrup Hospital, University of CopenhagenGlostrupDenmark

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