Clinical and radiologic approach to ‘typical’ versus antibody-related optic neuritis

Caron-Cantin, Marilou; Cestari, Dean M.; Fortin, Élizabeth

doi:10.1097/icu.0000000000000614

Cited by 13 publications

(13 citation statements)

References 24 publications

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“…However, some patients would present with recurrent disease despite testing negative for AQP4-Abs, confusing the physicians. With the recent availability of myelin oligodendrocyte glycoprotein antibody (MOG-Ab) testing in China, and the acceptance of MOG-Abs-associated disorders as a unique demyelinating disease of the central nervous system (CNS) 7 , the concept of ON as “atypical” depending on the antibody status, as well as the treatment strategy, has been updated 8 .…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics of optic neuritis phenotypes in a 3-year follow-up Chinese cohort

Feng

Chen

Zhao

et al. 2021

Sci Rep

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To evaluate the clinical characteristics of optic neuritis (ON) with different phenotypes. This prospective study recruited patients with new-onset ON between January 2015 and March 2017 who were followed-up for 3 years. They were divided into the myelin oligodendrocyte glycoprotein-seropositive (MOG-ON), aquaporin-4-seropositive (AQP4-ON), and double-seronegative (seronegative-ON) groups, and their clinical characteristics and imaging findings were evaluated and compared. Two-hundred-eighty patients (405 eyes) were included (MOG-ON: n = 57, 20.4%; AQP4-ON: n = 98, 35.0%; seronegative-ON: n = 125, 44.6%). The proportion of eyes with best-corrected visual acuity > 20/25 at the 3-year follow-up was similar between the MOG-ON and seronegative-ON groups; the proportion in both groups was higher than that in the AQP4-ON group (p < 0.001). Relapse rates were higher in the MOG-ON and AQP4-ON groups than in the seronegative-ON group (p < 0.001). Average retinal nerve fiber layer (RNFL) thickness at 3 years was similar between the MOG-ON and AQP4-ON groups (63.41 ± 13.39 and 59.40 ± 11.46 μm, p = 0.476) but both were thinner than the seronegative-ON group (74.06 ± 11.14 μm, p < 0.001). Macular ganglion cell-inner plexiform layer (GCIPL) revealed the same pattern. Despite RNFL and GCIPL thinning, the MOG-ON group’s outcome was as favorable as that of the seronegative-ON group, whereas the AQP4-ON group showed unsatisfactory results.

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Section: Introductionmentioning

confidence: 99%

Clinical characteristics of optic neuritis phenotypes in a 3-year follow-up Chinese cohort

Feng

Chen

Zhao

et al. 2021

Sci Rep

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“…Patients with distinct demyelinating lesions on the brain MRI were also excluded. 22,23…”

Section: Methodsmentioning

confidence: 99%

“…Patients with distinct demyelinating lesions on the brain MRI were also excluded. 22,23 Ophthalmic examinations All patients received complete ophthalmic examinations. BCVA was measured at every visit, including the onset, after IVMP treatment (1 day before PE therapy), the day after each PE therapy and at the 1-month follow-up visit.…”

Section: Study Subjectsmentioning

confidence: 99%

Vision improvement in severe acute isolated optic neuritis after plasma exchange treatment in Chinese population: a prospective case series study

Tan

et al. 2020

Ther Adv Neurol Disord

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Background: Plasma exchange (PE) is often considered as an effective treatment for neuromyelitis optica spectrum disorder (NMOSD) and several inflammatory demyelinating disorders of the central nervous system. This study aimed to evaluate the visual outcomes of Chinese patients with severe acute isolated optic neuritis (ON) who received PE therapy after high-dose intravenous methylprednisolone (IVMP) treatment. Methods: Thirty-seven acute isolated ON patients experiencing their first attack of severe visual impairment without neurological disability were recruited. All subjects received five cycles of double-filtration plasmapheresis. Visual acuity (VA) was documented at onset, 1 day before PE treatment, at each cycle of PE therapy and at the 1-month follow-up visit. Results: This study included 26 female (70.3%) and 11 male (29.7%) subjects, and 18 subjects (48.6%) had bilateral involvement. The time window between onset and PE treatment was 27.3 ± 12.7 days (range: 6–53 days). Mean VA (logMAR) of the studied eyes at onset, 1-day before PE treatment/after IVMP and after the fifth PE treatment were 3.41 ± 1.50, 2.61 ± 1.64 and 1.66 ± 1.52, respectively ( p < 0.001). Nineteen eyes (51.4%) showed no light perception at the onset, and 17 eyes (45.9%) improved to Snellen VA >20/800 after IVMP and PE treatments, among which five eyes (13.5%) recovered to Snellen VA 20/20 ( p < 0.001). Predictors of good visual outcome included body mass index [odds ratio (OR) = 0.734, p = 0.044], serum AQP4 antibody-positive status (OR = 0.004, p = 0.001), bilaterality (OR = 0.042, p = 0.008) and time window from onset to PE therapy per 1 day (OR = 0.79, p = 0.002). Conclusion: This study revealed that PE treatment effectively improves the visual outcomes of patients experiencing their first attack of severe acute isolated ON after high-dose IVMP treatment. Better visual outcomes can be achieved with early PE treatment.

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“…Therefore, these specific clinical and radiological features should alert clinicians about the more frequent risk of NMOSD or MOGAD, and to include antibody testing in cases of severe visual loss, being male, of older age, bilateral involvement, optic disk swelling, or specific radiological features. 26 Because a late diagnosis can be a lost opportunity for patient treatment, some authors have postulated that enhanced antibody testing could improve both the classification and prognosis of ON, 142 and that it should be performed in all ON cases without specific MRIbased MS feature. 143 Furthermore, the high diagnostic efficiency of the MOG-IgG test 115 supports its systematic use, especially when patients are managed by a front-line ophthalmologist who is not an expert in neuro-ophthalmology.…”

Section: Does the Classification Typical And Atypical On Still Make S...mentioning

confidence: 99%

Optic neuritis classification in 2021

Ducloyer¹,

Marignier

Wiertlewski³

et al. 2021

European Journal of Ophthalmology

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Optic neuritis (ON) can be associated with inflammatory disease of the central nervous system or can be isolated, with or without relapse. It can also be associated with infectious or systemic disease. These multiple associations based on a variety of clinical, radiological, and biological criteria that have changed over time have led to overlapping phenotypes: a single ON case can be classified in several ways simultaneously or over time. As early, intensive treatment is often required, its diagnosis should be rapid and precise. In this review, we present the current state of knowledge about diagnostic criteria for ON aetiologies in adults and children, we discuss overlapping phenotypes, and we propose a homogeneous classification scheme. Even if distinctions between typical and atypical ON are relevant, their phenotypes are largely overlapping, and clinical criteria are neither sensitive enough, nor specific enough, to assure a diagnosis. For initial cases of ON, clinicians should perform contrast enhanced MRI of the brain and orbits, cerebral spinal fluid analysis, and biological analyses to exclude secondary infectious or inflammatory ON. Systematic screening for MOG-IgG and AQP4-IgG IgG is recommended in children but is still a matter of debate in adults. Early recognition of neuromyelitis optica spectrum disorder, MOG-IgG-associated disorder, and chronic relapsing idiopathic optic neuritis is required, as these diagnoses require therapies for relapse prevention that are different from those used to treat multiple sclerosis.

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Clinical and radiologic approach to ‘typical’ versus antibody-related optic neuritis

Cited by 13 publications

References 24 publications

Clinical characteristics of optic neuritis phenotypes in a 3-year follow-up Chinese cohort

Clinical characteristics of optic neuritis phenotypes in a 3-year follow-up Chinese cohort

Vision improvement in severe acute isolated optic neuritis after plasma exchange treatment in Chinese population: a prospective case series study

Optic neuritis classification in 2021

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