Frequency of Autoantibodies and Connective Tissue Diseases in Chinese Patients with Optic Neuritis

Abstract

BackgroundOptic neuritis (ON) is often associated with other clinical or serological markers of connective tissue diseases (CTDs). To date, the effects of autoantibodies on ON are not clear.PurposeTo assess the prevalence, clinical patterns, and short outcomes of autoantibodies and Sjögren’s syndrome (SS) involvement in Chinese ON patients and evaluate the relationship between ON, including their subtypes, and autoantibodies.MethodsA total of 190 ON patients were divided into recurrent ON (RON), bilateral ON (BON), and isolated monocular ON (ION). Demographic, clinical, and serum autoantibodies data were compared between them with and without SS involvement. Serum was drawn for antinuclear antibody (ANA), extractable nuclear antigen antibodies (SSA/SSB), rheumatoid factor (RF), anticardiolipin antibodies (ACA), and anti-double-stranded DNA antibody (A-ds DNA), anticardiolipin antibody (ACLs), anti-β2-glycoprotein I (β2-GPI) and Aquaporin-4 antibodies (AQP4-Ab). Spectral-domain optical coherence tomography (SD-OCT) was used to evaluate the atrophy of the optic nerve.Results68 patients (35.79%) had abnormal autoantibodies, 26(13.68%) patients met diagnostic criteria for CTDs, including 15(7.89%) patients meeting the criteria for SS. Antibodies including SSA/SSB 23 (30.26%) (p1 and p 2<0.001) and AQP4–Ab10 (13.16%) (p1 = 0.044, p2 = 0.01) were significantly different in patients in the RON group when compared with those in the BON (P1 = RON VS ION) and ION (p2 = RON VS ION) groups. SS was more common in RON patients (p1 = 0.04, p2 = 0.028). There was no significant difference between SSA/SSB positive and negative patients in disease characteristics or severity. Similar results were obtained when SS was diagnosed in SSA/SSB positive patients.ConclusionRON and BON were more likely associated with abnormal autoantibodies; furthermore, AQP4 antibody, SSA/SSB and SS were more common in the RON patients. AQP4 antibodydetermination is crucial in RON patients who will develop NMO. However, when compared with other autoantibodies, SSA/SSB detected in patients was not significantly associated with disease characteristics or severity.

Simultaneous bilateral optic neuritis in China: clinical, serological and prognostic characteristics

“…A previous study by the present authors also found that AQP4‐IgG sero‐positive ON patients suffered more frequently from recurrent and bilateral ON (Li et al. ). But the prevalence of simultaneous bilateral ON, whether as a present symptom or as a clinical characteristic of already demonstrated NMO, has not been investigated in detail.…”

“…; Li et al. ), providing further support to the hypothesis that simultaneous bilateral ON is more closely related to NMO. Visual acuity (VA) of <0.1 during acute ON attacks was not significantly different between the bilateral and unilateral groups.…”

Thickness of macular inner retinal layers and peripapillary retinal nerve fibre layer in neuromyelitis optica spectrum optic neuritis and isolated optic neuritis with one episode

“…Serum and CSF were collected from all patients for NMO-IgG testing. The presence of NMO-IgG was analysed by both commercial enzyme-linked immunosorbent assays (ELISA) kits and extracellular live cell-staining immunofluorescence technique using transiently transfected AQP4-expressing cells, as described in our previous reports (Li et al 2014(Li et al , 2015. All patients underwent a comprehensive ophthalmic examination and standardized treatments.…”

Features of anti-aquaporin 4 antibody-seropositive Chinese patients with neuromyelitis optica spectrum optic neuritis

“…We also excluded those who had retinal lesions or other causative ocular diseases or had the presence of significant refractive errors (3D of spherical equivalent refraction or 2D of astigmatism), intraocular pressure of 21 mmHg higher, glaucoma, retinal disease, a history of media opacification, ocular pathologies affecting the cornea, lens, or vitreous or laser therapy. Patients with the hepatitis viral infection, human immunodeficiency virus (HIV) infection, syphilitics, lymphoma, graft-versushost disease, lymphoma, human T-lymphotropic virus Type I, or previous head or neck radiation were also excluded [17]. We also excluded the patients who had taken corticosteroids when they collected blood samples for the measurements of AQP4-Ab.…”