Evidence map›Paper›PMID 41144049›Full record

ArticleJournal of neurology2025

Rethinking routine lumbar puncture in isolated optic neuritis: results from a large cohort study.

Romain Deschamps, Marine Boudot de la Motte, Emeline Chaugne, Cedric Lamirel, Julien Savatovsky, Caroline Bensa, Aurelien Freiherr Von Seckendorff, Manon Philibert, Antoine Gueguen, Romain Marignier and 3 more

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Article in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Romain DeschampsDepartment of Neurology, Hôpital Fondation Adolphe de Rothschild, Service de Neurologie, Fondation Ophtalmologique Adolphe de Rothschild, 25 Rue Manin, 75019, Paris, France. rdeschamps@for.paris.ORCID http://orcid.org/0000-0001-6291-8771
Marine Boudot de la MotteDepartment of Neurology, Hôpital Fondation Adolphe de Rothschild, Service de Neurologie, Fondation Ophtalmologique Adolphe de Rothschild, 25 Rue Manin, 75019, Paris, France.
Emeline ChaugneDepartment of Neurology, Hôpital Fondation Adolphe de Rothschild, Service de Neurologie, Fondation Ophtalmologique Adolphe de Rothschild, 25 Rue Manin, 75019, Paris, France.
Cedric LamirelDepartment of Neuro-Ophthalmolology, Hôpital Fondation Adolphe de Rothschild, Paris, France.
Julien SavatovskyDepartment of Radiology, Hôpital Fondation Adolphe de Rothschild, Paris, France.
Caroline BensaDepartment of Neurology, Hôpital Fondation Adolphe de Rothschild, Service de Neurologie, Fondation Ophtalmologique Adolphe de Rothschild, 25 Rue Manin, 75019, Paris, France.
Aurelien Freiherr Von SeckendorffDepartment of Neurology, Hôpital Fondation Adolphe de Rothschild, Service de Neurologie, Fondation Ophtalmologique Adolphe de Rothschild, 25 Rue Manin, 75019, Paris, France.
Manon PhilibertDepartment of Neuro-Ophthalmolology, Hôpital Fondation Adolphe de Rothschild, Paris, France.
Antoine GueguenDepartment of Neurology, Hôpital Fondation Adolphe de Rothschild, Service de Neurologie, Fondation Ophtalmologique Adolphe de Rothschild, 25 Rue Manin, 75019, Paris, France.
Romain MarignierCentre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.
Catherine Vignal-ClermontDepartment of Neuro-Ophthalmolology, Hôpital Fondation Adolphe de Rothschild, Paris, France.
Augustin LeclerDepartment of Radiology, Hôpital Fondation Adolphe de Rothschild, Paris, France.
Caroline PapeixDepartment of Neurology, Hôpital Fondation Adolphe de Rothschild, Service de Neurologie, Fondation Ophtalmologique Adolphe de Rothschild, 25 Rue Manin, 75019, Paris, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLumbar puncture (LP) remains widely recommended in the diagnostic evaluation of isolated optic neuritis (ON), when brain MRI does not reveal lesions suggestive of multiple sclerosis (MS). However, the true clinical utility is unclear in the era of advanced serological and imaging diagnostics.

methodsIn this monocentric retrospective study of all consecutive adult patients with acute or subacute ON and no MS-like lesions on initial brain MRI, we analyzed the final etiological diagnoses, the specific contribution of LP, and treatment timing.

resultsAmong 184 patients, diagnoses at the end of the follow-up (median 15.3 months) included idiopathic ON (48.4%), myelin oligodendrocyte glycoprotein-IgG associated disease (MOGAD; 22.3%), MS (19.6%), neuromyelitis optica spectrum disorders (4.3%), sarcoidosis (4.3%), and chronic lymphocytic leukemia-related ON (CLL; 1.1%). LP contributed to the final diagnosis in only 4 cases (2,2%), including 2 MOGAD (MOG-IgG only in cerebrospinal fluid) and 2 chronic lymphocytic leukemia-related ON, always in conjunction with other tests and clinical context. Conversely, spinal or orbital MRI and antibody testing were key diagnostic tools. Median delay between MRI and LP was 3 days, contributing to a median 11-day interval from symptom onset to corticosteroid treatment initiation.

conclusionsRoutine LP has minimal diagnostic yield in isolated ON without MS-typical MRI findings and may delay treatment. Our results support a more selective, context-driven diagnostic strategy prioritizing MRI and antibody testing over systematic LP.

Indexed as

Optic NeuritisSpinal PunctureAdultAgedCohort StudiesFemaleFollow-Up StudiesHumansMagnetic Resonance ImagingMaleMiddle AgedMyelin-Oligodendrocyte GlycoproteinRetrospective StudiesYoung AdultMyelin-Oligodendrocyte GlycoproteinMRIMultiple sclerosisMyelin oligodendrocyte glycoproteinOptic neuritisSarcoidosis

Identifiers

PMID41144049

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.