| Abstract | Cilj istraživanja: Cilj ovog retrospektivnog istraživanje je odrediti učestalost akutnog
monosimptomaskog optičkog neuritisa i ispitati povezanost akutne epizode
monosimptomaskog optičkog neuritis i razvoja multiple skleroze.
Materijali i metode: Podaci za istraživanje su retrogradno prikupljeni iz medicinske
dokumentacije ispitanika. Ispitanici sa simptomima akutnog monosimptomatskog optičkog
neuritisa i abnormalanostima u oftalmološkom pregledu su bili uključeni u istraživanje, a
ispitanici s dijagnozom multiple skleroze, prethodno liječenim optičkim neuritisom i drugim
intraokularnim bolestima su bili isključeni iz istraživanja. 87 ispitanika je bilo podvrgnuto
pregledu oftalmologa i neurologa i pretrazi VEP-a tijekom hospitalizacije. Zdrastvene promjene
u ispitanika kasnije su se pratile oftalmološkim i neurološkim pregledom. Ako bi tijekom
razdoblja praćenja ispitanik razvio simptome multiple skleroze i ako bi nalaz MR mozga
pokazao nove lezije tada bi smatrali da je došlo do razvoja multiple skleroze.
Rezultati: Od 87 ispitanika 59 (67,8 %) ispitanika su bile žene, a 28 (32,2 %) ispitanika su bili
muškarci. Prosječna dob pri dijagnosticiranju optičkog neuritisa kod žena je bila 25,9 godina
(SD 11,3), a kod muškaraca 29,9 godina (SD 9,2). Godišnja stopa incidencije je bila 1,9 na 100
000 (95 % IP, 0,4 – 3,5) stanovnika. Godišnja stopa incidencije za muškarce je bila 1,2 (95%
IP, 0 – 2,9) slučaja na 100 000 stanovnika. Godišnja stopa incidencije za žene je bila 2,5 (95%
IP, 0,1 – 4,9) slučaja na 100 000 stanovnika. Izračunati relativni rizik za ženski spol bio je 1,4
(95 % IP, 0,4 - 6,6), što je statistički značajno. Najveća stopa incidencije pojave bolesti u oba
spola je u skupini ispitanika čija je životna dob između 20 i 29 godina, a njena vrijednost iznosi
4,9 (95 % IP, 0 - 11,4). Na incidenciju akutnog monosimptomatskog optičkog neuritisa,
godišnja doba značajno ne utječu (𝒙 = 6,81, p = 0,080). Od 87 ispitanika, 20 ispitanika (22,9 %)
je razvilo multiplu sklerozu. Medijan vremenskog razdoblja do dijagnosticiranja multiple
skleroze kod ispitanika je 25 (SE 8) mjeseci, (95 % IP, 9 - 41). Multipla skleroza se razvila kod
12,6 % ispitanika s monosimptomatskim optičkim neuritisom nakon 2 godine, kod 20,6 %
ispitanika nakon vremenskog razdoblja od 5 godina i kod 22,9 % ispitanika nakon jednog
desetljeća. Optički neuritis neznatno češče progredira u multiplu sklerozu kod ženskog spola
(𝒙
2 = 0,72, p = 0,3).
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Zaključak: Rizik razvoja multiple skleroze poslije epizode akutnog optičkog neuritisa prema
istraživanju provedenom u ovom diplomskom radu je umjeren. Optički neurtis je relativno često
„uvertira“ multiple skleroze zbog toga je potrebno poboljšati psihološku potporu pacijentima i
istraživati nove terapijske metode liječenja. |
| Abstract (english) | Objectives: The aim of this retrospective study is to determine the incidence of acute
monosymptomatic optic neuritis and to examine the association between an acute episode of
monosymptomatic optic neuritis and the development of multiple sclerosis.
Materials and methods: Data for the research were collected retrogradely from the medical
records of the patients. Patients with symptoms of acute monosymptomatic optic neuritis aged
between 18 and 46 and abnormalities in the ophthalmological examination were included in the
study and patients with a diagnosis of multiple sclerosis, previous optic neuritis treated with
corticosteroids and other intraocular diseases were excluded from the study. 87 patients were
examined by ophthalmologists and neurologists and examined by VEP during hospitalization.
A complete ophthalmological examination included visual acuity examination, color vision
examination and visual field examination assessed with the help of Goldmann's perimeter. The
patient's health condition was later followed up by an ophthalmological and neurological
examination. If the patient developed symptoms of multiple sclerosis during the follow-up
period and if the MR examination detected new lesions, then it would be considered that the
patient had a diagnosis of multiple sclerosis.
Results: Out of 87 patients, 59 (67,8 %) patients were women and 28 (32,2 %) patients were
men. The average age at diagnosis of optic neuritis in women was 25,9 years (SD 11,3) and in
men 29,9 years (SD 9,2). The annual incidence rate was 1,9 per 100 000 (95 % CI, 0,4 – 3,5)
population. The annual incidence rate for men was 1,2 (95 % CI, 0 – 2,9) cases per 100 000
population. The annual incidence rate for women was 2,5 (95 % CI, 0,1 – 4,9) cases per 100
000 population. The calculated relative risk for women was 1,4 (95 % CI, 0,4 – 6,6), which was
statistically significant. The highest incidence rate of the occurrence of the disease in both sexes
is in the group of patients whose age was between 20 and 29 years and the value was 4,9 (95 %
CI, 0 – 11,4). Seasons did not significantly affect the incidence of acute monosymptomatic optic
neuritis (𝒙 = 6,81, p = 0,080). Out of 87 patients, 20 patients (22,9 %) developed multiple
sclerosis. The median time to diagnosis of multiple sclerosis in patient was 25 (SE 8) months,
(95 % CI, 9 - 41). Multiple sclerosis developed in 12,6 % of patients with monosymptomatic
optic neuritis after 2 years, in 20,6 % of patients after a time period of 5 years, and in 22,9 % of
patients after a decade. Optic neuritis progressed slightly more often to multiple sclerosis in
49
women (𝒙
2 = 0,72, p = 0,3).
Conclusion: The risk of developing multiple sclerosis after an episode of acute optic neuritis
according to the research conducted in this graduation thesis is moderate. Optic neuritis is
relatively often the "overture" of multiple sclerosis which is reason why it is necessary to
improve psychological support for patients and research new therapeutic methods of treatment. |
