BACKGROUND: Short-term outcomes of optic neuritis (ON) have been well characterized. Limited data exists on longer-term visual outcomes in patients who present with ON. The large MSBase registry allows for characterization of long-term visual outcomes after ON. METHODS: Via the MSBase Registry, data on patients from 41 centers was collected during routine clinical and research visits. Physical and visual disability were measured using the expanded disability status scale (EDSS) and the visual function score (VFS). Inclusion criteria for this analysis included age ≥ 18 years, clinically isolated syndrome (CIS), ON-onset, baseline visit within 6 months of onset, and at least one follow-up visit. Survival analysis was used to evaluate the association of disease-modifying treatment with time to conversion to clinically definite MS or sustained EDSS/VFS progression. RESULTS: Data from 60,933 patients were obtained from the MSBase registry in July 2019. Of these, 1317 patients met inclusion criteria; 935 were treated at some point in disease course, while 382 were never treated. At baseline, mean age was 32.3 ± 8.8 years, 74% were female, median EDSS was 2 (IQR 1-2), and median VFS was 1 (IQR 0-2). Median follow-up time was 5.2 years (IQR 2.4-9.3). Treatment was associated with reduced risk and delayed conversion to clinically definite MS (HR = 0.70, p < 0.001), sustained EDSS progression (HR = 0.46, p < 0.0001) and sustained VFS (HR = 0.41, p < 0.001) progression. CONCLUSIONS: In the MSBase cohort, treatment after ON was associated with better visual and neurological outcomes compared to no treatment. These results support early treatment for patients presenting with ON as the first manifestation of MS.

A O S Giuseppe Moscati Avellino Italy

Amiri Hospital Kuwait City Kuwait

Azienda Sanitaria Unica Regionale Marche Ancona Province of Ancona Italy

Bakirkoy Hospital Of Mental Disorders And Neuro Bakirkoy Istanbul Turkey

Centro Internacional de Restauracion Neurologica La Habana Cuba

Charles University Prague and General University Hospital Prague Czech Republic

Cliniques Universitaires Saint Luc UCLouvain Brussels Belgium

Department of Medical and Surgical Sciences and Advanced Technologies University of Catania Catania Italy

Department of Medicine and Surgery University of Parma Italy

Department of Neurology New York University Grossman School of Medicine New York NY USA

Department of Neurology New York University Grossman School of Medicine New York NY USA; Department of Ophthalmology New York University Grossman School of Medicine New York NY USA

Department of Neurology New York University Grossman School of Medicine New York NY USA; Department of Population Health New York University Grossman School of Medicine New York NY USA

Department of Neurology New York University Grossman School of Medicine New York NY USA; Department of Population Health New York University Grossman School of Medicine New York NY USA; Department of Ophthalmology New York University Grossman School of Medicine New York NY USA

Department of Population Health New York University Grossman School of Medicine New York NY USA

Dokuz eylul uni faculty of medicine Izmir Turkey

Haydarpasa Numune Training and Research Hospital Istanbul Turkey

Hospital Universitario Virgen Macarena Seville Spain

IRCCS Istituto delle Scienze Neurologiche di Bologna Bologna Italy; Dipartimento di Scienze Biomediche e Neuromotorie Università di Bologna Bologna Italy

IRCCS Mondino Foundation Pavia Italy

Johns Hopkins University School of Medicine Baltimore MD USA

KTU Medical Faculty Farabi Hospital Trabzon Turkey

Monash University Melbourne Victoria Australia

MS Centre Royal Melbourne Hospital CORe Department of Medicine University of Melbourne Melbourne AU

MSBase Foundation Alfred Centre Melbourne Australia; Department of Clinical Neuroscience Karolinska Institute Stockholm Sweden

Neuro Rive Sud Quebec Canada

Neurologicka Klinika 1 LF UK Prague Czech Republic

Neurologicka Klinika Jihlava Jihlava Czech Republic

Nuovo Ospedale Civile S Agostino Estense Baggiovara MO Italy

Ondokuz Mayis Universitesi Samsun Turkey

University G d'Annunzio Chieti Pescara Italy

University of Modena and Reggio Emilia Modena Province of Modena Italy

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