In this study we aim to determine seasonal patterns underlying optic neuritis (ON) onset that may provide valuable epidemiologic information and help delineate causative or protective factors.
Single-centre retrospective chart review.
A database search of centralized electronic health records was completed using diagnostic codes employed at the Ottawa Eye Institute for data collection. Charts were reviewed for documentation supporting a diagnosis of ON falling into the following categories: multiple sclerosis ON and clinically isolated syndrome ON, myelin oligodendrocyte glycoprotein ON, neuromyelitis optica ON, and idiopathic ON. Date of onset, biological sex, and age were extracted from each chart. Data were analyzed for calculation of frequency by season and overall pooled seasonal trends of all cases of ON.
From the 218 included patients with ON, there was no statistically significant seasonal correlation. The overall trend of ON was lowest in winter and spring (22% and 23%, respectively) and highest in summer and fall (28% and 27% respective). Divided further, multiple sclerosis ON or clinically isolated syndrome ON rates (n = 144) were lowest in the spring (21%) and highest in fall (29%); myelin oligodendrocyte glycoprotein ON rates (n = 25) were lowest in winter (16%) and highest in summer and fall (both at 32%); neuromyelitis optica ON rates (n = 16) were lowest in fall (12.5%) and highest in winter and summer (both at 31.25%); and idiopathic ON rates (n = 33) were lowest in fall (18%) and highest in spring (33%).
The overall ON seasonal trend appears to have a predilection for the summer and fall months, which may be explained by warmer weather and viral infections as risk factors for multiple sclerosis relapse during those seasons.
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- Seasonal patterns in optic neuritis and multiple sclerosis: a meta-analysis.Journal of the neurological sciences. J Neurol Sci. 2000; 181: 56-64
- Relapse patterns in NMOSD: evidence for earlier occurrence of optic neuritis and possible seasonal variation.Front Neurol. 2020; 11: 537
- Seasonal distribution of attacks in aquaporin-4 antibody disease and myelin-oligodendrocyte antibody disease.J Neurol Sci. 2020; 415116881
National Research Council Canada. When do the seasons start? [Internet]. 2022. Available at: nrc.canada.ca/en/certifications-evaluations-standards/canadas-official-time/3-when-do-seasons-start (accessed March 10, 2022).
- Seasonality of viral infections: mechanisms and unknowns.Clinical microbiology and infection. Blackwell, Hoboken, NJ2012: 946-954 (Vol. 18)
- Latitude, sun exposure and vitamin D supplementation: associations with quality of life and disease outcomes in a large international cohort of people with multiple sclerosis.BMC Neurol. 2015; 15: 132
- Seasonality of multiple sclerosis and neuromyelitis optica exacerbations in Japan.Mult Scler. 2013; 19: 378-379
- Seasonal variation in attacks of neuromyelitis optica spectrum disorders and multiple sclerosis: evaluation of 794 attacks from a nationwide registry in Argentina.Mult Scler Relat Disord. 2022; 58103466
- A spring to summer shift of pro-inflammatory cytokine production in multiple sclerosis patients.J Neurol Sci. 2016; 360: 37-40
- Seasonal variation of onset in patients with anti-aquaporin-4 antibodies and anti-myelin oligodendrocyte glycoprotein antibody.J Neuroimmunol. 2020; 349577431
- Optic neuritis incidence is increased in spring months in patients with asymptomatic demyelinating lesions.Mult Scler. 2010; 16: 252-254
- Seasonality and autoimmune diseases: the contribution of the four seasons to the mosaic of autoimmunity.J Autoimmun. 2017; 82: 13-30
- Acute optic neuritis and the prognosis for multiple sclerosis.J Neurol Neurosurg Psychiatry. 1976; 39: 283-289
- Acute disseminated encephalomyelitis in children.Pediatrics. 2002; 110: e21
- Acute disseminated encephalomyelitis in childhood: epidemiologic, clinical and laboratory features.Pediatr Infect Dis J. 2004; 23: 756-764
- Risk of multiple sclerosis after idiopathic optic neuritis in a Pakistani population.Can J Neurol Sci. 2010; 37: 258-263
- Multiple sclerosis: long time modifications of seasonal differences in the frequency of clinical attacks.Neurol Sci. 2012; 33: 999-1003
- Historical changes of seasonal differences in the frequency of multiple sclerosis clinical attacks: a multicenter study.J Neurol. 2013; 260: 1258-1262
Published online: January 30, 2023
Accepted: January 6, 2023
Received in revised form: December 20, 2022
Received: October 14, 2022
Publication stageIn Press Corrected Proof
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