Adderley, N

Braithwaite, T

Denniston, A

Galloway, J

Mollan, S

Nirantharakumar, K

Petzold, A

Plant, G

Subramanian, A

English

UCL Discovery

  The epidemiology of optic neuritis in the United Kingdom and implications for consensus diagnostic criteria for multiple sclerosisAxel Petzold 1,2 MD PhD FRCP Anuradhaa Subramanian3 MScJames Galloway4 PhD FRCPNicola Adderley 3 PhDSusan Mollan 5 FRCOphthGordon T. Plant 1,2,6 MD FRCP FRCOphth FEANAlastair Denniston 3,7,8 PhD FRCOpthKrish Nirantharakumar 3,8 MDTasanee Braithwaite 3,6 MRCP FRCOphth DMAffiliations: 1 NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK; 2 The National Hospital for Neurology and Neurosurgery, Queen Square UCL Institute of Neurology,  London, UK; MS Centre & Neuro-ophthalmology Expertise Centre Amsterdam UMC, NL; 3 Institute of Applied Health Research, University of Birmingham, UK; 4 Centre for Rheumatic Diseases, King’s College London, UK; 5 Birmingham Neuro-Ophthalmology, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, UK; 6 The Medical Eye Unit, St Thomas’ Hospital NHS Foundation Trust, London, UK; 7 Health Data Research UK; 8 Institute of Inflammation and Ageing, University of Birmingham  DisclosuresAP reports personal fees from Novartis, Heidelberg Engineering, Zeiss, grants from Novartis, outside the submitted work; and AP is part of the steering committee of the OCTiMS study which is sponsored by Novartis. AP is part of the steering committee of Angio-OCT which is sponsored by Zeiss. SM reports other funding from Roche, other from Chugai pharma UK limited, other from Heidelberg Engineering, other from Allergan, other from Neurodiem, other from Santhera, other from Janssen, and other from Novaritis, outside the submitted work.KN reports grants from Health Data Research UK during the conduct of the study; and grants from NIHR, grants from MRC, personal fees from Sanofi, grants from AstraZeneca, personal fees from MSD, grants from Vifor, grants and personal fees from BI, grants from Diabetes UK, grants from BHF, grants from AAMD, outside the submitted work.AP and AD are supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Moorfields Eye Hospital National Health Service (NHS) Foundation Trust and University College London Institute of Ophthalmology. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health.  Background● The  epidemiology of optic neuritis (ON) has been studied less carefully than the epidemiology of multiple sclerosis (MS). The association of ON with many other diseases poses one of several challenges for inclusion of  the ON as a 5th location in consensus diagnostic criteria for MS● To investigate current trends in ON incidence, prevalence and associations with systemic and neurological diseases in the United Kingdom (UK)   Methods● Data on 75 million patient-years of follow up from● 11,086,469 UK patients from● The Health Improvement Network (THIN) for● A retrospective cross-sectional and population cohort study for the association of optic neuritis multiple sclerosis (MS) and 66 other immune-mediated inflammatory disease (IMID) https://doi.org/10.1016/B978-0-444-63432-0.00020-7   Cohort description  Characteristic at baseline ON % (n) No ON % (n) Single variable IRR (95% CI), p value Adjusted IRR (95% CI), p value)  Total, % (n) 2826 10,934,685    Gender Female, % (n) 69.4 (1,962) 50.9 (5,569,320) 2.26 (2.09-2.45), p<0.001 2.26 (2.08-2.45), p<0.001Age group at cohort entry            1-10 years 4.3 (121) 19.9 (2,070,338) 1 111-20 years 10.1 (284) 9.9 (1,081,405) 4.56 (3.69-5.64), p<0.001 4.53 (3.65-5.63), p<0.00121-30 years 24.9 (704) 18.2 (1,984,337) 7.81 (6.44-9.47), p<0.001 6.80 (5.50-8.40), p<0.00131-40 years 28.2 (796) 16.6 (1,814,484) 6.98 (5.77-8.45), p<0.001 6.04 (4.89-7.46), p<0.00141-50 years 16.7 (473) 12.1 (1,324,681) 4.84 (3.97-5.91), p<0.001 4.15 (3.33-5.16), p<0.00151-60 years 8.3 (235) 9.6 (1,045,254) 2.92 (2.35-3.64), p<0.001 2.45 (1.93-3.10), p<0.00161-70 years 4.4 (125) 7.0 (765,334) 2.21 (1.72-2.83), p<0.001 1.82 (1.39-2.38), p<0.00171-80 years 2.4 (67) 4.8 (526,666) 2.08 (1.55-2.81), p<0.001 1.69 (1.24-2.31), p<0.00181-90 years 0.7 (21) 2.5 (270,755) 2.11 (1.33-3.36), p=0.002 1.68 (1.05-2.69), p<0.00191-100 years 0 0.5 (50,687)    101+ years 0 0.0 (744)    Nation    England 68.8 (1,943) 71.3 (7,790,740) 1 1Scotland 16.0 (452) 14.1(1,538,041) 1.22 (1.10-1.35), p<0.001 1.19 (1.08-1.32), p=0.001Wales 10.1 (285) 11.0 (1,203,405) 0.91 (0.81-1.04), p=0.158 0.91 (0.80-1.03), p=0.147Northern Ireland 5.2 (146) 3.4 (402,499) 1.07 (0.90-1.26), p=0.437 1.08 (0.91-1.28), p=0.376  Incidence of ON22 year observation period Age  Past (OR) and future (HR) associations with ON  Association of ON with MS  Association of ON with other diseases  Conclusion● We describe trends in ON incidence, prevalence and associations with systemic and neurological diseases● This cohort study of >11 million patients reports ON incidence of 3.74 per 100,000 person-years, affecting 114 per 100,000 population in 2018 (76,279 people)● The incidence of ON is stable over the 22 year observation period on a UK population based level. The primary differential diagnosis is MS. For patient management it is important to note that the other IMID associated ON cases, paradoxically individually considered as a rare, cumulative outnumber MS-ON cases. This will be relevant for future revision of consensus MS diagnostic criteria, to minimize misdiagnosis  

The epidemiology of optic neuritis in the united kingdom and implications for consensus diagnostic criteria for multiple sclerosis

https://discovery.ucl.ac.uk/10149027/1/poster-ECTRIMS-axel-epidemiology.pdf

The epidemiology of optic neuritis in the united kingdom and implications for consensus diagnostic criteria for multiple sclerosis

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