Distinct clinical characteristics of atypical optic neuritis with seronegative aquaporin-4 antibody among Chinese patients

Zhou, Huanfen; Xu, Quangang; Zhao, Shilei; Wang, Wei; Wang, Junqing; Chen, Zhiye; Lin, Dasheng; Li, Xiaoming; Peng, Chunxia; Ai, Nanping; Wei, Shihui

doi:10.1136/bjophthalmol-2017-310157

Cited by 13 publications

(5 citation statements)

References 28 publications

(15 reference statements)

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“…We found only one male patient in the NMOSD group and no male patient in the MS group. These findings are different from other studies; the female:male ratio was 3:1-10.7:1 in the NMOSD group and 1.5:1-5.9:1 in the MS group [ 28 - 32 ], which is lower than the results of our study. Simultaneous bilateral involvement was found in 29.3% in the NMOSD group, 26.1% in the MS group and 21.7% in the idiopathic group which were not statistically significantly different among three groups.…”

Section: Discussioncontrasting

confidence: 99%

Clinical Characteristics, Treatment Outcomes and Predictive Factors in Optic Neuritis

Hansapinyo¹,

Vivattanaseth²

2018

TOOPHTJ

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Background:The causes, clinical presentations and treatment outcomes of optic neuritis are distinct among different populations. Early diagnosis based on clinical presentations plays an important role in treating optic neuritis patients.Objective: The study aimed to determine clinical characteristics, treatment outcomes and predictive factors of treatment outcomes in optic neuritis patients with and without demyelinating disease.Methods:A retrospective descriptive study of optic neuritis patients carried out between January 2009 and December 2016 was done. Univariate analysis and multivariate logistic regression analysis were used to evaluate the predictive factors of treatment outcomes.Results:Among 150 patients with optic neuritis, 58 patients were diagnosed with Neuromyelitis Optica Spectrum Disease (NMOSD), 23 patients were diagnosed with Multiple Sclerosis (MS) and 69 patients were idiopathic. The age at presentation in the NMOSD group was significantly younger than the MS group and the idiopathic group. The female:male ratio was significantly lower in the idiopathic group than in the NMOSD group. The initial Best Corrected Visual Activity (BCVA) of 20/20-20/60 (p = 0.001) and the idiopathic group (p =0.030) was associated with good visual outcomes. Initial BCVA of < 20/200 (p = 0.009) and the NMOSD group (p < 0.001) was associated with poor visual outcomes.Conclusion:NMOSD is a more common cause of optic neuritis than MS in Thai population. Female patients with poor initial VA, poor response to steroids treatment, and presenting recurrent attacks are highly suspicious for NMOSD. Optic neuritis without associated demyelinating disease has a better visual outcome and lower recurrence rate.

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Section: Discussioncontrasting

confidence: 99%

Clinical Characteristics, Treatment Outcomes and Predictive Factors in Optic Neuritis

Hansapinyo¹,

Vivattanaseth²

2018

TOOPHTJ

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“…Previous studies showed female predominance in ON, especially in NMOSD-ON patients [8]. Our previous study [16] showed that atypical ON with seronegative AQP4-Ab and MOG-Ab had distinct clinical features which included a male predominance, low relapse rate, and worse visual prognosis, which highlighted the need to increase our understanding of sex-specific aspect of ON to better prognostic assessment and further insight into ON pathophysiology. We evaluated our cohort's Chinese male patients with antibody-seropositive ON (Ab-ON) and found 57.9% (44/76) of these patients were seropositive for MOG-Ab.…”

Section: Discussionmentioning

confidence: 98%

Different Characteristics of Aquaporin-4 and Myelin Oligodendrocyte Glycoprotein Antibody-Seropositive Male Optic Neuritis in China

Song

Zhou

Yang

et al. 2019

Journal of Ophthalmology

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Purpose. To describe different clinical characteristics and prognosis of optic neuritis (ON) in male patients with seropositive aquaporin-4 antibody (AQP4-Ab) or myelin oligodendrocyte glycoprotein antibody (MOG-Ab) in China. Method. Males with ON were recruited from the Neuro-ophthalmology Department of the Chinese People’s Liberation Army, General Hospital from January 2016 to February 2018. They were assigned to two groups based on antibodies status: MOG-Ab-seropositive ON (MOG-ON) and aquaporin-4 Ab-seropositive ON (AQP4-ON). Results. Seventy-six male patients were assessed, including 44 MOG-ON (57.9%) and 32 AQP4-ON (42.1%). The MOG-ON patients were significantly younger at onset compared to the AQP4-ON group (p<0.001). Frequencies of optic disc swelling, presence of abnormal autoimmune antibodies, and elevated levels of CSF IgG were significantly higher in the AQP4-ON group than the MOG-ON group (p=0.040, p=0.016, and p=0.10, respectively). At the final visit, 85.3% of MOG-ON eyes had increased visual acuity (≥0.5) compared to 35.1% of AQP4-ON eyes (p<0.001). The ratio of this steroid-dependent condition is higher in MOG-ON patients than the AQP4-ON group (p<0.001). The ratio of conversion to NMO is higher in the AQP4-ON group than the MOG-ON group, with more AQP4-ON patients developing NMO by the follow-up (p=0.012). MOG-ON patients had thicker average peripapillary retinal nerve fiber layers and macular ganglion cell-inner plexiform than AQP4-ON patients (p=0.008 and p=0.012, respectively). Orbital MRI revealed more AQP4-ON patients had chiasmal involvement than MOG-ON patients (p<0.001). Conclusion. Male MOG-ON patients had different clinical features including earlier age of onset, higher optic disc swelling ratio, better visual acuity recovery, thicker peripapillary retinal nerve fiber and macular ganglion cell-inner plexiform layers, and less chiasmal involvement than male AQP4-ON patients. Serum antibody may be a potential biomarker for determining visual prognosis in male ON.

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“…It has been identified that NMOSD is more likely to develop in Asia, whereas MS is more prevalent in western countries [ 7 ]. Previously, we reported a cohort of Chinese ON patients with atypical clinical features and poor recovery [ 8 ]. African-American patients were also found to have more severe vision loss and less vision recovery [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Optic Neuritis in the Older Chinese Population: A 5-Year Follow-Up Study

Wang

Zhou

Qin

et al. 2017

Journal of Ophthalmology

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Objective This study aims to describe the clinical manifestations and outcomes in a cohort of older Chinese patients. Method A retrospective study of patients aged ≥ 45 years who had a first episode of optic neuritis (ON) between May 2008 and November 2012. Clinical features at onset and last follow-up were analyzed within subgroups (age 45–65 years and age ≥ 65 years). Results 76 patients (99 eyes) were included, of which 58% were females. The mean age at presentation was 55.53 ± 8.29 years (range: 45–83 years). Vision loss was severe at presentation, with initial best corrected vision activity (BCVA) < 20/200 in 93% and final BCVA < 20/200 in 53% of patients at 5-year follow-up. Final BCVA significantly correlated with the initial BCVA and peripapillary retinal nerve fiber layer. At last follow-up, 14.5% were diagnosed with neuromyelitis optica spectrum disorder (NMOSD), 1.3% were diagnosed with multiple sclerosis (MS), 5.2% with chronic relapsing inflammatory optic neuropathy, 1.3% with infectious ON, and 19.7% with autoimmune ON. None of the elderly group (≥65 years) developed NMOSD or MS. Conclusion Chinese patients in the age group ≥ 65 years with ON are less likely to develop NMOSD or MS. Notwithstanding, they had more severe visual loss at onset and poor recovery.

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Distinct clinical characteristics of atypical optic neuritis with seronegative aquaporin-4 antibody among Chinese patients

Cited by 13 publications

References 28 publications

Clinical Characteristics, Treatment Outcomes and Predictive Factors in Optic Neuritis

Clinical Characteristics, Treatment Outcomes and Predictive Factors in Optic Neuritis

Different Characteristics of Aquaporin-4 and Myelin Oligodendrocyte Glycoprotein Antibody-Seropositive Male Optic Neuritis in China

Optic Neuritis in the Older Chinese Population: A 5-Year Follow-Up Study

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