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Iancu R, Pirvulescu R, Anton N, Iancu G, Istrate S, Romanitan MO, Geamanu A, Popa Cherecheanu M. Visual Function Improvement after Plasma Exchange Therapy for Acute Optic Neuritis in Neuromyelitis Optica Spectrum Disorders: Case Series and Review. Diagnostics (Basel) 2024; 14:863. [PMID: 38732279 PMCID: PMC11083380 DOI: 10.3390/diagnostics14090863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 04/17/2024] [Accepted: 04/19/2024] [Indexed: 05/13/2024] Open
Abstract
OBJECTIVE Neuromyelitis optica (NMO) and neuromyelitis optica spectrum disorder (NMOSD) are autoimmune-mediated central nervous system disorders distinguished by the presence of serum aquaporine-4 IgG antibody (AQP4-Ab). The clinical panel comprises severe optic neuritis (ON) and transverse myelitis, which can result in incomplete recovery and a high risk of recurrence. METHODS This study aimed to evaluate the visual outcomes of three patients with severe acute ON in NMOSD that was non-responsive to intravenous methylprednisolone (IVMP), who received plasma exchange therapy (PLEX). We included three patients (P1, P2 and P3) with severe acute ON who had no improvement after IVMP treatment and were admitted to the ophthalmology department at the Emergency University Hospital Bucharest from January 2022 to September 2023. All three patients with ON were diagnosed in accordance with the criteria described by the Optic Neuritis Treatment Trial. All the subjects were experiencing their first attack. RESULTS The mean recruitment age was 35.3 ± 7.71. All patients were seropositive for the AQP4 antibody. All patients were tested for serum myelin oligodendrocyte glycoprotein (MOG) antibody but only one showed a positive test (P3). Lesions visible in orbital MRI indicated the involvement of retrobulbar, canalicular and/or intracranial segments. All three subjects had no response or incomplete remission after an IVMP protocol (5 days of 1000 mg intravenous methylprednisolone in sodium chloride 0.9%). The mean time from onset of optic neuritis to PLEX was 37.6 days. The PLEX treatment protocol comprised five cycles of plasma exchange treatment over 10 days, with a plasma exchange session every other day. An amount of 1 to 1.5 volumes of circulating plasma were dialyzed for 2-4 h. At 1 month after the completion of PLEX therapy, BCVA and VF parameters were improved in all three patients. CONCLUSION The treatment of ON remains subject to debate and is somewhat controversial. Plasma exchange must be considered as a rescue therapy when IVMP is insufficient for AQP4-ON patients. This study revealed that PLEX treatment effectively improves the visual outcomes of patients experiencing their first attack of severe acute isolated ON after high-dose IVMP treatment. This study suggests that PLEX may be associated with improved visual outcomes in NMOSD acute optic neuritis.
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Affiliation(s)
- Raluca Iancu
- Department of Ophthalmology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.I.); (S.I.); (A.G.)
| | - Ruxandra Pirvulescu
- Department of Ophthalmology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.I.); (S.I.); (A.G.)
| | - Nicoleta Anton
- Department of Ophthalmology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - George Iancu
- Department of Obstetrics-Gynecology, “Carol Davila” University of Medicine and Pharmacy, 020956 Bucharest, Romania;
| | - Sinziana Istrate
- Department of Ophthalmology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.I.); (S.I.); (A.G.)
| | - Mihaela Oana Romanitan
- Department of Internal Medicine, Section of Neurology, Södersjukhuset, 11883 Stockholm, Sweden;
| | - Aida Geamanu
- Department of Ophthalmology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.I.); (S.I.); (A.G.)
| | - Matei Popa Cherecheanu
- Department of Cardiovascular Surgery, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
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Erdağ E, Emekli AS, Gündüz T, Küçükali Cİ, Kürtüncü M, Tüzün E. Serum IgG of patients with relapsing inflammatory optic neuropathy immunoreacts with Sox2-positive glial cells of the optic nerve. Mult Scler Relat Disord 2023; 73:104694. [PMID: 37023542 DOI: 10.1016/j.msard.2023.104694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 03/30/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Given the significance of glial cells in maintenance of neurons, antibodies directed against glial cells of the optic nerve might reasonably be expected to have a pathogenic impact in relapsing inflammatory optic neuropathy (RION). METHODS We investigated IgG immunoreactive with the optic nerve tissue by indirect immunohistochemistry using sera of 20 RION patients. Commercial Sox2-antibody was used for double immunolabeling. RESULTS Serum IgG of 5 RION patients reacted with cells aligned in the interfascicular regions of the optic nerve. IgG binding sites significantly co-localized with the Sox2-antibody. CONCLUSION Our results suggest that a subset of RION patients may harbor anti-glial antibodies.
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A 10-Year Single-Center Study of the Clinical Characteristics of Optic Neuritis-Related NMOSD, MS, and Double Seronegative Optic Neuritis, Together with Factors Predicting Visual Outcomes. Vision (Basel) 2023; 7:vision7010016. [PMID: 36977296 PMCID: PMC10056788 DOI: 10.3390/vision7010016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/14/2023] [Accepted: 02/23/2023] [Indexed: 03/06/2023] Open
Abstract
The clinical characteristics of three types of optic neuritis (double seronegative optic neuritis; DN-ON, Neuromyelitis optica spectrum disorder-related optic neuritis; NMOSD-ON, and multiple sclerosis-related optic neuritis; MS-ON) were examined in order to identify factors that may affect good visual recovery in Thai patients. The study included patients diagnosed with three types of optic neuritis at Rajavithi Hospital between 2011 and 2020. Visual acuity at the end of 12 months was used as the treatment outcome. Multiple logistic regression analysis was used to evaluate potential predictors of good visual recovery. Of the 76 patients, 61 had optic neuritis, with DN-ON as the most common subtype (52.6%). MS-ON patients were significantly younger (28.3 ± 6.6 years, p = 0.002) and there was a female predominance in all subgroups (p = 0.076). NMOSD-ON patients had a significantly higher proportion of poor baseline VA (p < 0.001). None of the NMOSD-ON patients achieved 0.3 logMAR visual recovery in the 12-month period (p = 0.022). A delay in treatment with intravenous methylprednisolone (IVMP) for more than 7 days increased the risk of failure to gain 0.3 logMAR visual recovery by five times (OR 5.29, 95% CI 1.359–20.616, p = 0.016), with NMOSD-ON as the strongest predictor (OR 10.47, 95% CI; 1.095–99.993, p = 0.041). Early treatment with intravenous methylprednisolone may be important for achieving at least 0.3 logMAR visual recovery in Thai patients with optic neuritis.
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Carnero Contentti E, López PA, Criniti J, Pettinicchi JP, Cristiano E, Patrucco L, Bribiesca Contreras E, Gómez-Figueroa E, Flores-Rivera J, Correa-Díaz EP, Toral Granda AM, Ortiz Yepez MA, Gualotuña Pachacama WA, Piedra Andrade JS, Galleguillos L, Tkachuk V, Nadur D, Daccach Marques V, Soto de Castillo I, Casas M, Cohen L, Alonso R, Caride A, Lana-Peixoto M, Rojas JI. Chiasmatic lesions on conventional magnetic resonance imaging during the first event of optic neuritis in patients with neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein-associated disease in a Latin American cohort. Eur J Neurol 2021; 29:802-809. [PMID: 34799965 DOI: 10.1111/ene.15178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 11/04/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE Optic neuritis (ON) is often the initial symptom of neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein-associated disease (MOGAD). We aimed to compare the frequency and pattern of chiasmatic lesions in MOGAD-related ON (MOGAD-ON) and NMOSD-related ON (NMOSD-ON) using conventional brain imaging (magnetic resonance imaging [MRI]) in Latin America (LATAM). METHODS We reviewed the medical records and brain MRI (≤30 days from ON onset) of patients with a first event of MOGAD-ON and NMOSD-ON. Patients from Argentina (n = 72), Chile (n = 21), Ecuador (n = 31), Brazil (n = 30), Venezuela (n = 10) and Mexico (n = 82) were included. Antibody status was tested using a cell-based assay. Demographic, clinical, imaging and prognostic (as measured by the Visual Functional System Score [VFSS] of the Expanded Disability Status Scale) data were compared. RESULTS A total of 246 patients (208 NMOSD and 38 MOGAD) were included. No differences were found in gender and ethnicity between the groups. We observed chiasmatic lesions in 66/208 (31.7%) NMOSD-ON and in 5/38 (13.1%) MOGAD-ON patients (p = 0.01). Of these patients with chiasmatic lesions, 54/66 (81.8%) and 4/5 had associated longitudinally extensive optic nerve lesions, 45/66 (68%) and 4/5 had bilateral lesions, and 31/66 (47%) and 4/5 showed gadolinium-enhancing chiasmatic lesions, respectively. A positive correlation was observed between VFSS and presence of bilateral (r = 0,28, p < 0.0001), chiasmatic (r = 0.27, p = 0.0001) and longitudinally extensive lesions (r = 0,25, p = 0.0009) in the NMOSD-ON group, but no correlations were observed in the MOGAD-ON group. CONCLUSIONS Chiasmatic lesions were significantly more common in NMOSD than in MOGAD during an ON attack in this LATAM cohort. Further studies are needed to assess the generalizability of these results.
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Affiliation(s)
| | - Pablo A López
- Neuroimmunology Unit, Department of Neuroscience, Hospital Alemán, Buenos Aires, Argentina
| | - Juan Criniti
- Neuroimmunology Unit, Department of Neuroscience, Hospital Alemán, Buenos Aires, Argentina
| | - Juan Pablo Pettinicchi
- Neuroimmunology Unit, Department of Neuroscience, Hospital Alemán, Buenos Aires, Argentina
| | - Edgardo Cristiano
- Centro de Esclerosis Múltiple de Buenos Aires (CEMBA), Buenos Aires, Argentina
| | - Liliana Patrucco
- Centro de Esclerosis Múltiple de Buenos Aires (CEMBA), Buenos Aires, Argentina
| | | | - Enrique Gómez-Figueroa
- Division of Neurology, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - José Flores-Rivera
- Division of Neurology, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | | | | | | | | | | | | | - Verónica Tkachuk
- Neuroimmunology Section, Department of Neurology, Hospital de Clínicas "José de San Martín", Buenos Aires, Argentina
| | - Debora Nadur
- Neuroimmunology Section, Department of Neurology, Hospital de Clínicas "José de San Martín", Buenos Aires, Argentina
| | - Vanessa Daccach Marques
- Department of Neurosciences and Behavioral Sciences, Hospital das Clínicas Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | | | - Magdalena Casas
- Neurology Department, Hospital J.M. Ramos Mejía, University of Buenos Aires, Buenos Aires, Argentina
| | - Leila Cohen
- Neurology Department, Hospital J.M. Ramos Mejía, University of Buenos Aires, Buenos Aires, Argentina
| | - Ricardo Alonso
- Neurology Department, Hospital J.M. Ramos Mejía, University of Buenos Aires, Buenos Aires, Argentina
| | - Alejandro Caride
- Neuroimmunology Unit, Department of Neuroscience, Hospital Alemán, Buenos Aires, Argentina
| | - Marco Lana-Peixoto
- Department of Neurology, Federal University of Minas Gerais Medical School, Belo Horizonte, Brazil
| | - Juan Ignacio Rojas
- Centro de Esclerosis Múltiple de Buenos Aires (CEMBA), Buenos Aires, Argentina.,Service of Neurology, Hospital Universitario de CEMIC, Buenos Aires, Argentina
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Hickman SJ, Petzold A. Update on Optic Neuritis: An International View. Neuroophthalmology 2021; 46:1-18. [PMID: 35095131 PMCID: PMC8794242 DOI: 10.1080/01658107.2021.1964541] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/26/2021] [Accepted: 07/31/2021] [Indexed: 10/20/2022] Open
Abstract
Previously, optic neuritis was thought to be typical, i.e. idiopathic or multiple sclerosis (MS) related, associated with a good visual prognosis, or atypical, i.e. not associated with MS and requiring corticosteroids or plasma exchange for vision to recover. More recently, the importance of optic neuritis in neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein (MOG) antibody disease has become more appreciated. The results of the Optic Neuritis Treatment Trial (ONTT) has influenced how optic neuritis is treated around the world. For this review we surveyed the international literature on optic neuritis in adults. Our aims were first to find the reported incidence of optic neuritis in different countries and to ascertain what percentage of cases were seropositive for anti-aquaporin 4 and anti-MOG antibodies, and second, to document the presenting features, treatment, and outcomes from a first episode of the different types of optic neuritis from these countries, and to compare the results with the outcomes of the ONTT cohort. From these data we have sought to highlight where ambiguities currently lie in how to manage optic neuritis and have made recommendations as to how future treatment trials in optic neuritis should be carried out in the current antibody testing era.
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Affiliation(s)
- Simon J. Hickman
- Department of Neurology, Royal Hallamshire Hospital, Sheffield, UK
| | - Axel Petzold
- Expertise Centrum Neuro-ophthalmology, Departments of Neurology & Ophthalmology, Amsterdam Umc, Amsterdam, The Netherlands
- Department of Neuro-Ophthalmology, Moorfields Eye Hospital, London, UK
- Department of Neuro-Ophthalmology, The National Hospital For Neurology And Neurosurgery, London, UK
- Department of Molecular Neurosciences, Ucl Institute of Neurology, London, UK
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6
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Ueki S, Hatase T, Kiyokawa M, Kawachi I, Saji E, Onodera O, Fukuchi T, Igarashi H. Visual outcome of aquaporin-4 antibody-positive optic neuritis with maintenance therapy. Jpn J Ophthalmol 2021; 65:699-703. [PMID: 34279748 DOI: 10.1007/s10384-021-00858-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 06/22/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To assess the effect of maintenance therapy on visual outcomes in preventing recurrences one year after first onset in patients with aquaporin-4 antibody (AQP4Ab)-positive optic neuritis. STUDY DESIGN Retrospective study. METHODS The medical charts of 56 patients with optic neuritis (22 with AQP4Ab-positive and 34 with AQP4Ab-negative) at Niigata University Medical and Dental Hospital were retrospectively analyzed. Clinical characteristics, including visual acuity and number of recurrences one year after first onset, were compared among patients who were AQP4Ab-positivie with and those without maintenance therapy such as oral prednisolone and azathioprine, as well as those who were AQP4Ab-negative. RESULTS The mean ages were 49.3 and 45.2 years in the AQP4Ab-positive and the AQP4Ab-negative groups. The female to male ratio was 21:1 and 18:16 in the two groups, respectively. Multiple between-group comparison showed a statistically significant difference in visual acuity one year after first onset between the AQP4Ab-positive without maintenance therapy group and the AQP4Ab-negative group (0.05 (median, same applies below) vs. 1.0, p < 0.01). There was also a statistically significant difference in the number of recurrences in the year after first onset between the AQP4Ab-positive with and without maintenance therapy groups (1 vs. 0, p < 0.01). CONCLUSION This study demonstrates that patients with AQP4Ab-positive optic neuritis without maintenance therapy had the poorest visual acuity and the most recurrences one year after first onset. These results indicate that reducing the number of recurrences with maintenance therapy could improve the visual outcomes in patients with AQP4Ab-positive optic neuritis.
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Affiliation(s)
- Satoshi Ueki
- Center for Integrated Human Brain Science, Brain Research Institute, Niigata University, Asahimachi-dori 1-757, Chuo-ku, Niigata, 951-8585, Japan. .,Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
| | - Tetsuhisa Hatase
- Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Megumi Kiyokawa
- Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Izumi Kawachi
- Department of Neurology, Brain Research Institute, Niigata University, Niigata, Japan.,Comprehensive Medical Education Center, Niigata University School of Medicine, Niigata, Japan
| | - Etsuji Saji
- Department of Neurology, Brain Research Institute, Niigata University, Niigata, Japan
| | - Osamu Onodera
- Department of Neurology, Brain Research Institute, Niigata University, Niigata, Japan
| | - Takeo Fukuchi
- Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Hironaka Igarashi
- Center for Integrated Human Brain Science, Brain Research Institute, Niigata University, Asahimachi-dori 1-757, Chuo-ku, Niigata, 951-8585, Japan
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Restrepo-Aristizábal C, Giraldo LM, Giraldo YM, Pino-Pérez AM, Álvarez-Gómez F, Franco CA, Tobón JV, Ascencio JL, Zuluaga MI. PLEX: the best first-line treatment in nmosd attacks experience at a single center in Colombia. Heliyon 2021; 7:e06811. [PMID: 33948520 PMCID: PMC8080073 DOI: 10.1016/j.heliyon.2021.e06811] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/08/2021] [Accepted: 04/12/2021] [Indexed: 02/09/2023] Open
Abstract
Objective Primary outcome was to evaluate complete improvement at six months after acute treatment in NMOSD relapses. Methods Retrospective observational cohort study of patients with diagnosis of NMOSD admitted for acute attacks. We performed an explanatory analysis using the univariate, bivariate and multivariate logistic regression approach. We compared survival curves using the Kaplan Meier analysis and estimated the median time for the main outcome. Results In the univariate analysis, basal EDSS score, AQP4-IgG positivity, PLEX as a first-line treatment (IVMP + PLEX), less systemic complications related to acute treatment and total attack history were independently associated with complete improvement at six months. After adjusting for confounding variables and using multivariate analysis by Cox Regression, positive AQ4-IgG (HR 0.04, 95% CI: 0.02–0.66) and IVMP + PLEX (HR 5.1, 95% CI: 3.9–66.4), were kept as independent factors associated to time to complete improvement. Time from admission to PLEX initiation and complete improvement at six months had a median of seven days (95% CI: 5.2–8.8). In secondary effects, there were no statistical differences between the groups. Conclusions PLEX + IVMP is the treatment of choice for NMOSD relapses and should be initiated as early as possible.
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Affiliation(s)
- C Restrepo-Aristizábal
- Neurology, Instituto Neurológico de Colombia (INDEC) Medellín, Colombia.,Neurology, CES University Medellín, Colombia
| | - L M Giraldo
- Neurology, Instituto Neurológico de Colombia (INDEC) Medellín, Colombia.,Neurology, CES University Medellín, Colombia
| | - Y M Giraldo
- Epidemiology, Biostatistics CES University; Medellín, Colombia
| | - A M Pino-Pérez
- Neurology, Instituto Neurológico de Colombia (INDEC) Medellín, Colombia.,Neurology, CES University Medellín, Colombia
| | - F Álvarez-Gómez
- Neurology, Instituto Neurológico de Colombia (INDEC) Medellín, Colombia.,Neurology, CES University Medellín, Colombia
| | - C A Franco
- Neurology, Instituto Neurológico de Colombia (INDEC) Medellín, Colombia.,Neurology, CES University Medellín, Colombia
| | - J V Tobón
- Neurology, Instituto Neurológico de Colombia (INDEC) Medellín, Colombia.,Neurology, CES University Medellín, Colombia
| | - J L Ascencio
- Neurorradiology, Instituto Neurológico de Colombia, Medellín, Colombia
| | - M I Zuluaga
- Neurology, Instituto Neurológico de Colombia (INDEC) Medellín, Colombia.,Neurology, CES University Medellín, Colombia
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Filippatou AG, Mukharesh L, Saidha S, Calabresi PA, Sotirchos ES. AQP4-IgG and MOG-IgG Related Optic Neuritis-Prevalence, Optical Coherence Tomography Findings, and Visual Outcomes: A Systematic Review and Meta-Analysis. Front Neurol 2020; 11:540156. [PMID: 33132999 PMCID: PMC7578376 DOI: 10.3389/fneur.2020.540156] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 08/25/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Optic neuritis (ON) is a cardinal manifestation of multiple sclerosis (MS), aquaporin-4 (AQP4)-IgG-, and myelin oligodendrocyte glycoprotein (MOG)-IgG-associated disease. However, the prevalence of AQP4-IgG seropositivity and MOG-IgG seropositivity in isolated ON is unclear, and studies comparing visual outcomes and optical coherence tomography (OCT)-derived structural retinal measures between MS-ON, AQP4-ON, and MOG-ON eyes are limited by small sample sizes. Objectives: (1) To assess the prevalence of AQP4-IgG and MOG-IgG seropositivity among patients presenting with isolated ON; (2) to compare visual outcomes and OCT measures between AQP4-ON, MOG-ON, and MS-ON eyes. Methods: In this systematic review and meta-analysis, a total of 65 eligible studies were identified by PubMed search. Statistical analyses were performed with random effects models. Results: In adults with isolated ON, AQP4-IgG seroprevalence was 4% in non-Asian and 27% in Asian populations, whereas MOG-IgG seroprevalence was 8 and 20%, respectively. In children, AQP4-IgG seroprevalence was 0.4% in non-Asian and 15% in Asian populations, whereas MOG-IgG seroprevalence was 47 and 31%, respectively. AQP4-ON eyes had lower peri-papillary retinal nerve fiber layer (pRNFL; -11.7 μm, 95% CI: -15.2 to -8.3 μm) and macular ganglion cell + inner plexiform layer (GCIPL; -9.0 μm, 95% CI: -12.5 to -5.4 μm) thicknesses compared with MS-ON eyes. Similarly, pRNFL (-11.2 μm, 95% CI: -21.5 to -0.9 μm) and GCIPL (-6.1 μm, 95% CI: -10.8 to -1.3 μm) thicknesses were lower in MOG-ON compared to MS-ON eyes, but did not differ between AQP4-ON and MOG-ON eyes (pRNFL: -1.9 μm, 95% CI: -9.1 to 5.4 μm; GCIPL: -2.6 μm, 95% CI: -8.9 to 3.8 μm). Visual outcomes were worse in AQP4-ON compared to both MOG-ON (mean logMAR difference: 0.60, 95% CI: 0.39 to 0.81) and MS-ON eyes (mean logMAR difference: 0.68, 95% CI: 0.40 to 0.96) but were similar in MOG-ON and MS-ON eyes (mean logMAR difference: 0.04, 95% CI: -0.05 to 0.14). Conclusions: AQP4-IgG- and MOG-IgG-associated disease are important diagnostic considerations in adults presenting with isolated ON, especially in Asian populations. Furthermore, MOG-IgG seroprevalence is especially high in pediatric isolated ON, in both non-Asian and Asian populations. Despite a similar severity of GCIPL and pRNFL thinning in AQP4-ON and MOG-ON, AQP4-ON is associated with markedly worse visual outcomes.
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Affiliation(s)
- Angeliki G Filippatou
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Loulwah Mukharesh
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Shiv Saidha
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Peter A Calabresi
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Elias S Sotirchos
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Carnero Contentti E, Rojas JI, Cristiano E, Marques VD, Flores-Rivera J, Lana-Peixoto M, Navas C, Papais-Alvarenga R, Sato DK, Soto de Castillo I, Correale J. Latin American consensus recommendations for management and treatment of neuromyelitis optica spectrum disorders in clinical practice. Mult Scler Relat Disord 2020; 45:102428. [DOI: 10.1016/j.msard.2020.102428] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 02/06/2023]
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10
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Carnero Contentti E, Daccach Marques V, Soto de Castillo I, Tkachuk V, Ariel B, Castillo MC, Cristiano E, Diégues Serva GB, dos Santos AC, Finkelsteyn AM, López PA, Patrucco L, Molina O, Pettinicchi JP, Toneguzzo V, Caride A, Rojas JI. Clinical features and prognosis of late-onset neuromyelitis optica spectrum disorders in a Latin American cohort. J Neurol 2020; 267:1260-1268. [DOI: 10.1007/s00415-020-09699-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 01/02/2020] [Accepted: 01/05/2020] [Indexed: 01/04/2023]
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11
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Carnero Contentti E, Marques VD, Soto de Castillo I, Tkachuk V, Barreira AA, Caride A, Castillo MC, Cristiano E, de Aquino Cruz C, Braga Diégues Serva G, Santos ACD, Labarca R, Lavigne Moreira C, López PA, Miguez J, Molina O, Pettinicchi JP, Rojas JI. Brain and spinal MRI features distinguishing MS from different AQP4 antibody serostatus NMOSD at disease onset in a cohort of Latin American patients. Mult Scler 2019; 26:945-954. [PMID: 31124748 DOI: 10.1177/1352458519849517] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE We aimed to evaluate magnetic resonance imaging (MRI) previously used criteria (Matthews's criteria, MC) for differentiating multiple sclerosis (MS) from neuromyelitis optica spectrum disorders (NMOSD) in Caucasian and non-Caucasian populations (Argentina, Brazil and Venezuela) with positive (P-NMOSD), negative (N-NMOSD), and unknown (U-NMOSD) aquaporin-4 antibody serostatus at disease onset and to assess the added diagnostic value of spinal cord MRI in these populations. METHODS We reviewed medical records, and MRIs were assessed by two blinded evaluators and were scored using MC. Short-segment transverse myelitis (STM) was added as a new criterion. MC sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined. RESULTS We included 282 patients (MS = 188 and NMOSD = 94). MC applied to the entire cohort showed 97.8% sensitivity, 82.9% specificity, 92.0% PPV, and 95.1% NPV for differentiating MS from NMOSD. A subanalysis applied only to non-Caucasian (MS = 89 and NMOSD = 47) showed 100% sensitivity, 80.8% specificity, 90.8% PPV, and 100% NPV. Similar sensitivity, specificity, PPV, and NPV of MC for MS versus P-NMOSD (n = 55), N-NMOSD (n = 28), and U-NMOSD (n = 21) were observed. CONCLUSION MC distinguished MS from NMOSD of all serostatus in a Latin American cohort that included non-Caucasian populations. Addition of STM to MC did not raise the accuracy significantly.
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Affiliation(s)
| | - Vanessa Daccach Marques
- Department of Neurosciences and Behavioral Sciences, Hospital das Clínicas, Ribeirão Preto Medical School, University of de São Paulo, São Paulo, Brazil
| | | | - Verónica Tkachuk
- Neuroimmunology Unit, Department of Neurology, Hospital de Clínicas "José de San Martín," Buenos Aires, Argentina
| | - Amilton Antunes Barreira
- Department of Neurosciences and Behavioral Sciences, Hospital das Clínicas, Ribeirão Preto Medical School, University of de São Paulo, São Paulo, Brazil
| | - Alejandro Caride
- Neuroimmunology Unit, Department of Neuroscience, Hospital Alemán, Buenos Aires, Argentina
| | - Maria C Castillo
- Neurology Department, Hospital Universitario de Maracaibo, Maracaibo, Venezuela
| | - Edgardo Cristiano
- Centro de Esclerosis Múltiple de Buenos Aires (CEMBA), Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Camila de Aquino Cruz
- Department of Neurosciences and Behavioral Sciences, Hospital das Clínicas, Ribeirão Preto Medical School, University of de São Paulo, São Paulo, Brazil
| | - Gabriel Braga Diégues Serva
- Department of Neurosciences and Behavioral Sciences, Hospital das Clínicas, Ribeirão Preto Medical School, University of de São Paulo, São Paulo, Brazil
| | - Antonio Carlos Dos Santos
- Department of Neurosciences and Behavioral Sciences, Hospital das Clínicas, Ribeirão Preto Medical School, University of de São Paulo, São Paulo, Brazil
| | - Rossanny Labarca
- Neurology Department, Hospital Universitario de Maracaibo, Maracaibo, Venezuela
| | - Carolina Lavigne Moreira
- Department of Neurosciences and Behavioral Sciences, Hospital das Clínicas, Ribeirão Preto Medical School, University of de São Paulo, São Paulo, Brazil
| | - Pablo A López
- Neuroimmunology Unit, Department of Neuroscience, Hospital Alemán, Buenos Aires, Argentina
| | - Jimena Miguez
- Centro de Esclerosis Múltiple de Buenos Aires (CEMBA), Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Omaira Molina
- Neurology Department, Hospital Universitario de Maracaibo, Maracaibo, Venezuela
| | - Juan Pablo Pettinicchi
- Neuroimmunology Unit, Department of Neuroscience, Hospital Alemán, Buenos Aires, Argentina
| | - Juan Ignacio Rojas
- Centro de Esclerosis Múltiple de Buenos Aires (CEMBA), Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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