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Does Neuroretinitis Rule Out Multiple Sclerosis?-Reply
CPT Vernon C. Parmley, MC, USA
Ophthalmology Service Department of Surgery Box 277 Letterman Army Medical Center Presidio of San Francisco, CA 94129-6700
Arch Neurol. 1989;46(4):358.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings. |
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In Reply.—
The comments of Drs Wilson and Smith are appreciated. We agree that longer follow-up and more patients would have made our study better.1 However, our data were still significant by comparison using Fisher's Exact Test, a method particularly suited for comparing small samples. We were also aware of the more recent follow-up data of the original prospective study by Cohen et al2 and Rizzo and Lessell.3 These new data are significant in that they suggest that a single isolated episode of optic neuritis is essentially an early sign of multiple sclerosis. This being the case, differentiating between demyelinating and nondemyelinating causes of optic neuritis can have prognostic significance.
As we stated in our article, we feel the pathogenesis of optic neuritis in multiple sclerosis is secondary to a primary inflammation of myelin, whether it occurs in the posterior nerve, where the edema cannot be observed directly, or in
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