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Moheb N, Chen JJ. The neuro-ophthalmological manifestations of NMOSD and MOGAD-a comprehensive review. Eye (Lond) 2023; 37:2391-2398. [PMID: 36928226 PMCID: PMC10397275 DOI: 10.1038/s41433-023-02477-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/07/2023] [Accepted: 02/28/2023] [Indexed: 03/18/2023] Open
Abstract
Optic neuritis (ON) is one of the most frequently seen neuro-ophthalmic causes of vision loss worldwide. Typical ON is often idiopathic or seen in patients with multiple sclerosis, which is well described in the landmark clinical trial, the Optic Neuritis Treatment Trial (ONTT). However, since the completion of the ONTT, there has been the discovery of aquaporin-4 (AQP4) and myelin oligodendrocyte glycoprotein (MOG) antibodies, which are biomarkers for neuromyelitis optica spectrum disorder (NMOSD) and MOG antibody-associated disease (MOGAD), respectively. These disorders are associated with atypical ON that was not well characterised in the ONTT. The severity, rate of recurrence and overall outcome differs in these two entities requiring prompt and accurate diagnosis and management. This review will summarise the characteristic neuro-ophthalmological signs in NMOSD and MOGAD, serological markers and radiographic findings, as well as acute and long-term therapies used for these disorders.
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Affiliation(s)
- Negar Moheb
- Department of Ophthalmology and Neurology, Mayo Clinic, Rochester, MN, USA
| | - John J Chen
- Department of Ophthalmology and Neurology, Mayo Clinic, Rochester, MN, USA.
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2
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Tian G, Sun X, Wang M. Optic Neuritis. Neuroophthalmology 2022. [DOI: 10.1007/978-981-19-4668-4_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Feng C, Chen Q, Zhao G, Li Z, Chen W, Sha Y, Sun X, Wang M, Tian G. Clinical characteristics of optic neuritis phenotypes in a 3-year follow-up Chinese cohort. Sci Rep 2021; 11:14603. [PMID: 34272440 PMCID: PMC8285465 DOI: 10.1038/s41598-021-93976-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 07/05/2021] [Indexed: 11/09/2022] Open
Abstract
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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Affiliation(s)
- Chaoyi Feng
- Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Qian Chen
- Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Guixian Zhao
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhenxin Li
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Weimin Chen
- Department of Neurology, Shanghai Deji Hospital, Shanghai, China
| | - Yan Sha
- Department of Radiology, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China
| | - Xinghuai Sun
- Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China.,State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Min Wang
- Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China. .,State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, China.
| | - Guohong Tian
- Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China. .,State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, China.
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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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Ma X, Kermode AG, Hu X, Qiu W. Risk of relapse in patients with neuromyelitis optica spectrum disorder: Recognition and preventive strategy. Mult Scler Relat Disord 2020; 46:102522. [PMID: 33007726 DOI: 10.1016/j.msard.2020.102522] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/09/2020] [Accepted: 09/18/2020] [Indexed: 11/25/2022]
Abstract
Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune inflammatory disorder of the central nervous system (CNS) that is mainly associated with serum autoantibodies against aquaporin-4 (AQP4) in astrocytes. The relapsing clinical course of NMOSD, which can be blinding and disabling due to severe visual impairment, spinal cord lesions and a group of brain syndromes, suggests the importance of accurately evaluating the likelihood and severity of relapse at an early stage of the disease. To date, many risk factors have been revealed in association with relapse, and only some of them are supported by substantial evidence. Furthermore, while the clinical use of conventional immunosuppressants is mostly empirical, an increasing number of emerging therapies for monoclonal antibodies have been confirmed by several randomized placebo-controlled trials to be effective and safe for relapse prevention. In this review, we summarize the reported risk factors that may influence the frequency, symptoms, severity and prognosis of relapse in NMOSD, as well as the efficacy and safety of emerging therapies for relapse prevention. All of these results enable us to better recognize patients who are at higher risk of relapse and suggest more effective monoclonal antibody therapies for use in these patients.
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Affiliation(s)
- Xiaoyu Ma
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, China
| | - Allan G Kermode
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, China; Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Perth, WA, Australia; Department of Neurology, Sir Charles Gairdner Hospital, Queen Elizabeth II Medical Centre, Perth, WA, Australia; Institute of Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia
| | - Xueqiang Hu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, China
| | - Wei Qiu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, China.
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Abstract
PURPOSE OF REVIEW To summarize recent developments in the classification, investigation and management of pediatric optic neuritis (PON). RECENT FINDINGS A recent surge in interest surrounding antibodies to myelin oligodendrocyte glycoprotein antibody (MOG-Ab) has instigated a paradigm shift in our assessment of children with PON. This serological marker is associated with a broad spectrum of demyelinating syndromes that are clinically and radiologically distinct from multiple sclerosis (MS) and aquaporin-4 antibody positive neuromyelitis optica spectrum disorder (AQP4+NMOSD). Optic neuritis is the most common presenting phenotype of MOG-Ab positive-associated disease (MOG+AD). MOG-Ab seropositivity is much more common in the pediatric population and it predicts a better prognosis than MS or AQP4+NMOSD, except in the subset that exhibit a recurrent phenotype. SUMMARY A better grasp of MOG+AD features and its natural history has facilitated more accurate risk stratification of children after a presenting episode of PON. Consequently, the initial investigation of PON has broadened to include serology, along with neuroimaging and cerebrospinal fluid analysis. Acute treatment of PON and chronic immunotherapy is also becoming better tailored to the suspected or confirmed diagnoses of MS, AQP4+NMOSD and MOG+AD.
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Affiliation(s)
- Jane H. Lock
- Departments of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, United States
| | - Nancy J. Newman
- Departments of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, United States
- Departments of Ophthalmology, Neurology, Emory University School of Medicine, Atlanta, Georgia, United States
- Departments of Ophthalmology, Neurological Surgery, Emory University School of Medicine, Atlanta, Georgia, United States
| | - Valérie Biousse
- Departments of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, United States
- Departments of Ophthalmology, Neurology, Emory University School of Medicine, Atlanta, Georgia, United States
| | - Jason H. Peragallo
- Departments of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, United States
- Departments of Ophthalmology, Pediatrics, Emory University School of Medicine, Atlanta, Georgia, United States
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Mekhasingharak N, Laowanapiban P, Siritho S, Satukijchai C, Prayoonwiwat N, Jitprapaikulsan J, Chirapapaisan N. Optical coherence tomography in central nervous system demyelinating diseases related optic neuritis. Int J Ophthalmol 2018; 11:1649-1656. [PMID: 30364209 DOI: 10.18240/ijo.2018.10.12] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 04/10/2018] [Indexed: 12/20/2022] Open
Abstract
AIM To compare the thickness of the peripapillary retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) among patients with various forms of optic neuritis (ON) and to identify whether any particular parameters or their thinning pattern can be used to distinguish the type of ON. METHODS This prospective study was conducted at the Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Thailand, between January, 2015 and December, 2016. We enlisted patients over 18 years of age with history of ON and categorized patients into 4 groups: 1) aquaporin 4 antibodies (AQP4-IgG) positive; 2) multiple sclerosis (MS); 3) myelin oligodendrocyte glycoprotein antibodies (MOG-IgG) positive; 4) idiopathic-ON patients. Healthy controls were also included during the same study period. All patients underwent complete ophthalmological examination and spectral domain optical coherence tomography (OCT) imaging to analyze RNFL and GCIPL thickness after at least 3mo since the last episode of acute ON. The generalized estimating equation (GEE) models were used to compare the data amongst ON groups. RESULTS Among 87 previous ON eyes from 57 patients (43 AQP4-IgG+ON, 17 MS-ON, 8 MOG-IgG+ON, and 19 idiopathic-ON), mean logMAR visual acuity of AQP4-IgG+ON, MS-ON, MOG-IgG+ON, and idiopathic-ON groups was 0.76±0.88, 0.12±0.25, 0.39±0.31, and 0.75±1.08, respectively. Average, superior, and inferior RNFL were significantly reduced in AQP4-IgG+ON, MOG-IgG+ON and idiopathic-ON eyes, relative to those of MS-ON. Differences were not statistically significant for RNFL or GCIPL between the AQP4-IgG+ON and MOG-IgG+ON groups, whereas visual acuity in MOG-IgG+ON was slightly, but not significantly, better (0.39 vs 0.76). Although RNFL thickness in MOG-IgG+ON was significantly reduced as compared to MS-ON, mean visual acuity and GCIPL were not different. CONCLUSION Thinning of superior and inferior quadrants of RNFL are more commonly seen in MOG-IgG+ON and AQP4-IgG+ON. Long term visual acuity in MOG-IgG+ON is often better than AQP4-IgG+ON, whereas the structural change from OCT is comparable.
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Affiliation(s)
- Nattapong Mekhasingharak
- Department of Ophthalmology, Naresuan University Hospital, Naresuan University, Phitsanulok 65000, Thailand
| | | | - Sasitorn Siritho
- Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.,Bumrungrad International Hospital, Bangkok 10110, Thailand
| | - Chanjira Satukijchai
- Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.,Bangkok Hospital Headquarters, Bangkok 10310, Thailand
| | - Naraporn Prayoonwiwat
- Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Jiraporn Jitprapaikulsan
- Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Niphon Chirapapaisan
- Department of Ophthalmology, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
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The application of RNFL thickness detection in early differential diagnosis among various types of idiopathic optic neuritis. J Clin Neurosci 2018; 55:82-85. [PMID: 30007523 DOI: 10.1016/j.jocn.2018.06.052] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 06/25/2018] [Indexed: 01/19/2023]
Abstract
In this study, we attempted to investigate the application of RNFL thickness detection in the early differential diagnosis among various types of idiopathic optic neuritis (ION). In comparison with 19 healthy controls (HC), retrospective analysis of quadrant RNFL thickness in 83 patients with ION was performed, including eighteen multiple sclerosis (MS), forty-five neuromyelitis optica spectrum disorder (NMOSD), twenty patients with other idiopathic optic neuritis (O-ION). Our results showed that mean and every quadrant RNFL thickness of MS, NMOSD and O-ION were thinner than those of HC (P < 0.05). In comparison with MS and O-ION, NMOSD group had thinner RNFL thickness in nasal quadrant (P < 0.05). No significant difference in each quadrant RNFL thickness between MS-ON and O-ION was suggested (P > 0.05). Mean and every quadrant RNFL thickness of unaffected eyes of MS-ON were not different from those of HC (P > 0.05). We concluded that for patients only with simple optic neuritis, NMOSD has a significantly thinner RNFL thickness in nasal quadrant than MS and O-ION, which may contribute to the clinical differentiation and therapy among various types of idiopathic optic neuritis.
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Hu SJ, Lu PR. Retinal ganglion cell-inner plexiform and nerve fiber layers in neuromyelitis optica. Int J Ophthalmol 2018; 11:89-93. [PMID: 29375997 DOI: 10.18240/ijo.2018.01.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 08/11/2017] [Indexed: 11/23/2022] Open
Abstract
AIM To determine the thickness of the retinal ganglion cell-inner plexiform layer (GCIPL) and the retinal nerve fiber layer (RNFL) in patients with neuromyelitis optica (NMO). METHODS We conducted a cross-sectional study that included 30 NMO patients with a total of 60 eyes. Based on the presence or absence of optic neuritis (ON), subjects were divided into either the NMO-ON group (30 eyes) or the NMO-ON contra group (10 eyes). A detailed ophthalmologic examination was performed for each group; subsequently, the GCIPL and the RNFL were measured using high-definition optical coherence tomography (OCT). RESULTS In the NMO-ON group, the mean GCIPL thickness was 69.28±21.12 µm, the minimum GCIPL thickness was 66.02±10.02 µm, and the RNFL thickness were 109.33±11.23, 110.47±3.10, 64.92±12.71 and 71.21±50.22 µm in the superior, inferior, temporal and nasal quadrants, respectively. In the NMO-ON contra group, the mean GCIPL thickness was 85.12±17.09 µm, the minimum GCIPL thickness was 25.39±25.1 µm, and the RNFL thicknesses were 148.33±23.22, 126.36±23.45, 82.21±22.30 and 83.36±31.28 µm in the superior, inferior, temporal and nasal quadrants, respectively. In the control group, the mean GCIPL thickness was 86.98±22.37 µm, the minimum GCIPL thickness was 85.28±10.75 µm, and the RNFL thicknesses were 150.22±22.73, 154.79±60.23, 82.33±7.01 and 85.62±13.81 µm in the superior, inferior, temporal and nasal quadrants, respectively. The GCIPL and RNFL were thinner in the NMO-ON contra group than in the control group (P<0.05); additionally, the RNFL was thinner in the inferior quadrant in the NMO-ON group than in the control group (P<0.05). Significant correlations were observed between the GCIPL and RNFL thickness measurements as well as between thickness measurements and the two visual field parameters of mean deviation (MD) and corrected pattern standard deviation (PSD) in the NMO-ON group (P<0.05). CONCLUSION The thickness of the GCIPL and RNFL, as measured using OCT, may indicate optic nerve damage in patients with NMO.
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Affiliation(s)
- Sai-Jing Hu
- Department of Ophthalmology, the First Affiliated Hospital of Suzhou University, Suzhou 215000, Jiangsu Province, China.,Department of Ophthalmology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Pei-Rong Lu
- Department of Ophthalmology, the First Affiliated Hospital of Suzhou University, Suzhou 215000, Jiangsu Province, China
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10
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Zhao G, Chen Q, Huang Y, Li Z, Sun X, Lu P, Yan S, Wang M, Tian G. Clinical characteristics of myelin oligodendrocyte glycoprotein seropositive optic neuritis: a cohort study in Shanghai, China. J Neurol 2017; 265:33-40. [PMID: 29101456 DOI: 10.1007/s00415-017-8651-4] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/01/2017] [Accepted: 10/18/2017] [Indexed: 12/31/2022]
Abstract
Qualitative and quantitative visual outcomes of Asian optic neuritis (ON) patients with seropositive myelin oligodendrocyte glycoprotein (MOG) antibodies remain unknown. We retrospectively evaluated a cohort of new-onset ON patients in Shanghai, China between January 2015 and December 2016. Serum MOG and aquaporin-4 (AQP4) antibodies were detected using cell-based assays, and patients were followed-up for at least 6 months. The clinical characteristics and optical coherence tomography (OCT) results were evaluated in the MOG-seropositive optic neuritis (MOG-ON), AQP4-seropositive (AQP4-ON), and double seronegative (Seronegative-ON) patients. Best-corrected visual acuity (BCVA) and peripapillary retinal nerve fiber layer (RNFL) thickness after 6 months of follow-up were compared. Among MOG-ON (n = 49, 64 eyes), AQP4-ON (n = 76, 102 eyes), and Seronegative-ON patients (n = 100, 116 eyes), the percentages of BCVAs better than 0.8 (20/25) at the 6-month visit were 67.19, 19.60, and 72.41%, respectively, which showed no statistical difference between MOG-ON and Seronegative-ON patients (p = 0.198), but were better than the AQP4-ON patients (P = 0.001). The average peripapillary RNFLs measured 6 months after the attack were 58.03 ± 8.73, 64.34 ± 12.88, and 78.12 ± 13.34 μm for the MOG-ON, AQP4-ON, and Seronegative-ON patients, respectively. There was no statistical difference between MOG-ON and AQP4-ON patients (P = 0.089), but both were thinner than Seronegative-ON patients (P = 0.001). The visual acuity in MOG-ON patients was as good as Seronegative-ON patients, whereas the RNFL of the optic nerve head showed a significant thinning as in the AQP4-ON patients.
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Affiliation(s)
- Guixian Zhao
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Qian Chen
- Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Yongheng Huang
- Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Zhenxin Li
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xinghuai Sun
- Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China.,State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Ping Lu
- Department of Radiology, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China
| | - S Yan
- Department of Radiology, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China
| | - Min Wang
- Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China. .,State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, China.
| | - Guohong Tian
- Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China. .,State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, China.
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11
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Peng A, Qiu X, Zhang L, Zhu X, He S, Lai W, Chen L. Evaluation of the retinal nerve fiber layer in neuromyelitis optica spectrum disorders: A systematic review and meta-analysis. J Neurol Sci 2017; 383:108-113. [PMID: 29246594 DOI: 10.1016/j.jns.2017.10.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 10/19/2017] [Accepted: 10/19/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND An increasing number of studies have investigated the value of optical coherence tomography in patients with neuromyelitis optica (NMO) spectrum disorders; however, no systematic review has been performed to date. We aimed to systematically review and investigate the possibility of differentiating NMO and multiple sclerosis (MS) via an optical coherence tomography measurement. METHODS Electronic databases, including MEDLINE, EMBASE and Web of Science, were systematically searched up to June 2017. A meta-analysis was performed to compare the retinal nerve fiber layer (RNFL) thickness between patients with NMO and MS (or healthy controls). RESULTS Twenty-four studies were identified. The meta-analysis demonstrated that the RNFL loss was substantially more severe in NMO than in MS; however, subclinical axon damage was also found in eyes without optic neuritis in NMO. The intereye RNFL difference between eyes with or without optic neuritis was more prominent in NMO (-30.98μm) than in MS (-9.87μm). CONCLUSION The RNFL loss was more severe in NMO than in MS, and the intereye RNFL difference between eyes with or without optic neuritis may be useful in differentiating NMO from MS.
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Affiliation(s)
- Anjiao Peng
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiangmiao Qiu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Lin Zhang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Xi Zhu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Shixu He
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Wanlin Lai
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Lei Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
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Mateo J, Esteban O, Martínez M, Grzybowski A, Ascaso FJ. The Contribution of Optical Coherence Tomography in Neuromyelitis Optica Spectrum Disorders. Front Neurol 2017; 8:493. [PMID: 29085325 PMCID: PMC5649178 DOI: 10.3389/fneur.2017.00493] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 09/04/2017] [Indexed: 12/03/2022] Open
Abstract
Neuromyelitis optica spectrum disorders (NMOSD) comprises a group of central nervous system disorders of inflammatory autoimmune origin that mainly affect the optic nerves and the spinal cord and can cause severe visual and general disability. The clinical signs are similar to those of multiple sclerosis (MS), with the result that it is often difficult to differentiate between the two, thus leading to misdiagnosis. As the treatment and prognosis of NMOSD and MS are different, it is important to make an accurate and early diagnosis of NMOSD. Optical coherence tomography (OCT) is a non-invasive technique that enables a quantitative study of the changes that the optic nerve and the macula undergo in several neurodegenerative diseases. Many studies have shown that some of these changes, such as retinal nerve fiber layer thinning or microcystic macular edema, can be related to alterations in the brain due to neurodegenerative disorders. The purpose of this mini-review is to show how OCT can be useful for the diagnosis of NMOSD and follow-up of affected patients, as well as for the differential diagnosis with MS.
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Affiliation(s)
- Javier Mateo
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Olivia Esteban
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Mireya Martínez
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Andrzej Grzybowski
- Department of Ophthalmology, Poznan City Hospital, Poznan, Poland.,Chair of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland
| | - Francisco Javier Ascaso
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.,Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
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