Retrospective studies have demonstrated disparate outcomes following acute optic neuritis in individuals of African descent compared with Caucasians. However, published analyses of the prospectively collected Optic Neuritis Treatment Trial (ONTT) data did not identify an association between worse visual outcomes and African race.
To investigate the association among race, gender, and age with visual outcomes following acute optic neuritis through application of longitudinal data analysis techniques to the ONTT data set.
Secondary analysis of the ONTT (a prospective, randomized, controlled trial) data set. Our models included effects of treatment (placebo, oral prednisone, IV methylprednisolone), time and treatment-time interaction as well as demographic covariates of age, gender and race.
ONTT data were collected at multiple centers in the United States.
Black(n=58) and White(n=388) subjects presenting with acute optic neuritis who enrolled in the ONTT within 8 days of symptom onset were included in analyses.
Main outcome measures
logMAR visual acuity (VA) and contrast sensitivity (CS) in the affected eye were modeled using two-stage mixed effect regression techniques. All available follow-up data from baseline to 15–18 years were included.
The data did not identify a relationship of age, gender, or treatment groups with VA or CS outcomes. Race was significantly related to CS (p<0.001) and VA (p<0.001) over a 15 year period following acute optic neuritis with black race being associated with worse scores for both.
Conclusions and Relevance
Race appears to be associated with contrast sensitivity and visual acuity outcomes in affected eyes following acute optic neuritis. To our knowledge, this is the largest cohort of black subjects with optic neuritis that has been analyzed, and the first evidence from a prospectively collected data set that supports a hypothesis of race-dependent visual outcomes in optic neuritis.