2
|
Yang Q, Xu Y, Bin X, Chan KP, Chen S, Qian Z, Yao Y, Yuan XL, Qiu K, Huang Y, Ng TK. Combined treatment of human mesenchymal stem cells and green tea extract on retinal ganglion cell regeneration in rats after optic nerve injury. Exp Eye Res 2024; 239:109787. [PMID: 38211683 DOI: 10.1016/j.exer.2024.109787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/15/2023] [Accepted: 01/09/2024] [Indexed: 01/13/2024]
Abstract
Retinal ganglion cell (RGC) death and axonal loss cause irreversible vision loss upon optic nerve (ON) injury. We have independently demonstrated that mesenchymal stem cells (MSCs) and green tea extract (GTE) promote RGC survival and axonal regeneration in rats with ON injury. Here we aimed to evaluate the combined treatment effect of human bone marrow-derived MSCs (hBM-MSCs) and GTE on RGC survival and axonal regeneration after ON injury. Combined treatment of hBM-MSCs and GTE promoted RGC survival and neurite outgrowth/axonal regeneration in ex vivo retinal explant culture and in rats after ON injury. GTE increased Stat3 activation in the retina after combined treatment, and enhanced brain-derived neurotrophic factor secretion from hBM-MSCs. Treatment of 10 μg/mL GTE would not induce hBM-MSC apoptosis, but inhibited their proliferation, migration, and adipogenic and osteogenic differentiation in vitro with reducing matrix metalloproteinase secretions. In summary, this study revealed that GTE can enhance RGC protective effect of hBM-MSCs, suggesting that stem cell priming could be a prospective strategy enhancing the properties of stem cells for ON injury treatment.
Collapse
Affiliation(s)
- Qichen Yang
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Yanxuan Xu
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Xin Bin
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Kwok Ping Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Shaowan Chen
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Zhen Qian
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Yao Yao
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Xiang-Ling Yuan
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Kunliang Qiu
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Yuqiang Huang
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Tsz Kin Ng
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.
| |
Collapse
|
3
|
Chen JJ, Flanagan EP, Pittock SJ, Stern NC, Tisavipat N, Bhatti MT, Chodnicki KD, Tajfirouz DA, Jamali S, Kunchok A, Eggenberger ER, Nome MAD, Sotirchos ES, Vasileiou ES, Henderson AD, Arnold AC, Bonelli L, Moss HE, Navarro SEV, Padungkiatsagul T, Stiebel-Kalish H, Lotan I, Wilf-Yarkoni A, Danesh-Meyer H, Ivanov S, Huda S, Forcadela M, Hodge D, Poullin P, Rode J, Papeix C, Saheb S, Boudot de la Motte M, Vignal C, Hacohen Y, Pique J, Maillart E, Deschamps R, Audoin B, Marignier R. Visual Outcomes Following Plasma Exchange for Optic Neuritis: An International Multicenter Retrospective Analysis of 395 Optic Neuritis Attacks. Am J Ophthalmol 2023; 252:213-224. [PMID: 36822570 PMCID: PMC10363193 DOI: 10.1016/j.ajo.2023.02.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/14/2023] [Accepted: 02/14/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE To evaluate the effectiveness of plasma exchange (PLEX) for optic neuritis (ON). METHODS We conducted an international multicenter retrospective study evaluating the outcomes of ON following PLEX. Outcomes were compared to raw data from the Optic Neuritis Treatment Trial (ONTT) using a matched subset. RESULTS A total of 395 ON attack treated with PLEX from 317 patients were evaluated. The median age was 37 years (range 9-75), and 71% were female. Causes of ON included multiple sclerosis (108), myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) (92), aquaporin-4-IgG-positive neuromyelitis optica spectrum disorder (AQP4+NMOSD) (75), seronegative-NMOSD (34), idiopathic (83), and other (3). Median time from onset of vision loss to PLEX was 2.6 weeks (interquartile range [IQR], 1.4-4.0). Median visual acuity (VA) at the time of PLEX was count fingers (IQR, 20/200-hand motion), and median final VA was 20/25 (IQR, 20/20-20/60) with no differences among etiologies except MOGAD-ON, which had better outcomes. In 81 (20.5%) ON attacks, the final VA was 20/200 or worse. Patients with poor outcomes were older (P = .002), had worse VA at the time of PLEX (P < .001), and longer delay to PLEX (P < .001). In comparison with the ONTT subset with severe corticosteroid-unresponsive ON, a final VA of worse than 20/40 occurred in 6 of 50 (12%) PLEX-treated ON vs 7 of 19 (37%) from the ONTT treated with intravenous methylprednisolone without PLEX (P = .04). CONCLUSION Most ON attacks improved with PLEX, and outcomes were better than attacks with similar severity in the ONTT. The presence of severe vision loss at nadir, older age, and longer delay to PLEX predicted a worse outcome whereas MOGAD-ON had a more favorable prognosis. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.
Collapse
Affiliation(s)
- John J Chen
- Departments of Ophthalmology (J.J.C., N.C.S., K.D.C., D.A.T., S.J.); Neurology (J.J.C., E.P.F., S.J.P., N.T., D.A.T., A.K.).
| | - Eoin P Flanagan
- Neurology (J.J.C., E.P.F., S.J.P., N.T., D.A.T., A.K.); Laboratory Medicine and Pathology (E.P.F., S.J.P.); Center for MS and Autoimmune Neurology (E.P.F., S.J.P., A.K.), Mayo Clinic, Rochester, Minnesota, USA
| | - Sean J Pittock
- Neurology (J.J.C., E.P.F., S.J.P., N.T., D.A.T., A.K.); Laboratory Medicine and Pathology (E.P.F., S.J.P.); Center for MS and Autoimmune Neurology (E.P.F., S.J.P., A.K.), Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - M Tariq Bhatti
- The Permanente Medical Group (M.T.B.), Kaiser Permanente-Northern California, Roseville, California, USA
| | | | - Deena A Tajfirouz
- Departments of Ophthalmology (J.J.C., N.C.S., K.D.C., D.A.T., S.J.); Neurology (J.J.C., E.P.F., S.J.P., N.T., D.A.T., A.K.)
| | - Sepideh Jamali
- Departments of Ophthalmology (J.J.C., N.C.S., K.D.C., D.A.T., S.J.)
| | - Amy Kunchok
- Neurology (J.J.C., E.P.F., S.J.P., N.T., D.A.T., A.K.); Center for MS and Autoimmune Neurology (E.P.F., S.J.P., A.K.), Mayo Clinic, Rochester, Minnesota, USA; Department of Neurology, Cleveland Clinic (A.K.), Cleveland, Ohio, USA
| | - Eric R Eggenberger
- Departments of Neurology, Neurosurgery, and Neuro-Ophthalmology, Mayo Clinic (E.R.E.), Jacksonville, Florida, USA
| | - Marie A Di Nome
- Departments of Ophthalmology (M.A.D.N.); Neurosurgery, Mayo Clinic (M.A.D.N.), Scottsdale, AZ
| | - Elias S Sotirchos
- Department of Neurology, Johns Hopkins University (E.S.S., E.S.V., A.D.H.), Baltimore, Maryland, USA
| | - Eleni S Vasileiou
- Department of Neurology, Johns Hopkins University (E.S.S., E.S.V., A.D.H.), Baltimore, Maryland, USA
| | - Amanda D Henderson
- Department of Neurology, Johns Hopkins University (E.S.S., E.S.V., A.D.H.), Baltimore, Maryland, USA; Department of Ophthalmology, Johns Hopkins University School of Medicine (A.D.H.), Baltimore, Maryland, USA
| | - Anthony C Arnold
- Department of Ophthalmology, University of California Los Angeles (A.C.A., L.B.), Los Angeles, California, USA
| | - Laura Bonelli
- Department of Ophthalmology, University of California Los Angeles (A.C.A., L.B.), Los Angeles, California, USA
| | - Heather E Moss
- Department of Neurology & Neurological Sciences, Stanford University (H.E.M.), Palo Alto, California, USA; Department of Ophthalmology, Stanford University (H.E.M., S.E.V.N., T.P.), Palo Alto, California, USA
| | | | - Tanyatuth Padungkiatsagul
- Department of Ophthalmology, Stanford University (H.E.M., S.E.V.N., T.P.), Palo Alto, California, USA; Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital (T.P.), Mahidol University, Bangkok, Thailand
| | - Hadas Stiebel-Kalish
- Department of Ophthalmology (H.S.-K.), Neuro-Ophthalmology Division, Rabin Medical Center and Sackler School of Medicine, Tel Aviv University, Israel; Felsenstein Medical Research Center (H.S.-K.), Tel Aviv University, Israel
| | - Itay Lotan
- Department of Neurology, Rabin Medical Center, Sackler School of Medicine (I.L., A.W.-Y.), Tel Aviv University, Israel
| | - Adi Wilf-Yarkoni
- Department of Neurology, Rabin Medical Center, Sackler School of Medicine (I.L., A.W.-Y.), Tel Aviv University, Israel
| | - Helen Danesh-Meyer
- Department of Ophthalmology, University of Auckland, New Zealand, and Vision Research Foundation (H.D.-M., S.I.), Auckland, New Zealand
| | - Stefan Ivanov
- Department of Ophthalmology, University of Auckland, New Zealand, and Vision Research Foundation (H.D.-M., S.I.), Auckland, New Zealand
| | - Saif Huda
- Department of Neurology, The Walton Centre NHS Foundation Trust (S.H., M.F.), Liverpool, United Kingdom
| | - Mirasol Forcadela
- Department of Neurology, The Walton Centre NHS Foundation Trust (S.H., M.F.), Liverpool, United Kingdom
| | - David Hodge
- Department of Quantitative Health Sciences, Mayo Clinic (D.H.), Jacksonville, Florida
| | - Pascale Poullin
- Department of Neurology, University Hospital of Marseille (P.P., J.R., B.A.), Marseille, France; Aix-Marseille University, CRMBM UMR 7339, CNRS (P.P., J.R., B.A.), Marseille, France
| | - Julie Rode
- Department of Neurology, University Hospital of Marseille (P.P., J.R., B.A.), Marseille, France; Aix-Marseille University, CRMBM UMR 7339, CNRS (P.P., J.R., B.A.), Marseille, France
| | - Caroline Papeix
- Department of Neurology, Pitie-Salpetriere Hospital, APHP (C.P., S.S., E.M.), Paris, France; Centre de référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (MIRCEM) (C.P., S.S., E.M.); Department of Neurology, Adolphe de Rothschild Foundation Hospital (C.P., M.B.d.l.M., R.D.), Paris, France
| | - Samir Saheb
- Department of Neurology, Pitie-Salpetriere Hospital, APHP (C.P., S.S., E.M.), Paris, France; Centre de référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (MIRCEM) (C.P., S.S., E.M.)
| | - Marine Boudot de la Motte
- Department of Neurology, Adolphe de Rothschild Foundation Hospital (C.P., M.B.d.l.M., R.D.), Paris, France
| | - Catherine Vignal
- Department of Neuro-Ophthalmology, Adolphe de Rothschild Foundation Hospital (C.V.), Paris, France
| | - Yael Hacohen
- Department of Neurology, Great Ormond Street Hospital for Children (Y.H.), London, United Kingdom; Queen Square Multiple Sclerosis Centre, UCL Institute of Neurology, Faculty of Brain Sciences, University College London (Y.H.), London, United Kingdom
| | - Julie Pique
- Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (MIRCEM), Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon (J.P., R.M.), Lyon, France
| | - Elisabeth Maillart
- Department of Neurology, Pitie-Salpetriere Hospital, APHP (C.P., S.S., E.M.), Paris, France; Centre de référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (MIRCEM) (C.P., S.S., E.M.)
| | - Romain Deschamps
- Department of Neurology, Adolphe de Rothschild Foundation Hospital (C.P., M.B.d.l.M., R.D.), Paris, France
| | - Bertrand Audoin
- Department of Neurology, University Hospital of Marseille (P.P., J.R., B.A.), Marseille, France; Aix-Marseille University, CRMBM UMR 7339, CNRS (P.P., J.R., B.A.), Marseille, France
| | - Romain Marignier
- Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (MIRCEM), Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon (J.P., R.M.), Lyon, France
| |
Collapse
|
5
|
Fu J, Wang Y, Li H, Zhou H, Song H, Sun M, Xu Q, Tan S, Wei S. Efficacy of Plasma Exchange Treatment for Demyelinating Optic Neuritis Associated with Various Serum Antibodies: A Prospective Cohort Study. Neurol Ther 2022; 11:797-813. [PMID: 35397098 PMCID: PMC9095770 DOI: 10.1007/s40120-022-00344-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/11/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION To evaluate the value of plasma exchange (PE) for patients with three subtypes of demyelinating optic neuritis (ON): aquaporin-4 (AQP4) antibody-positive ON (AQP4-ON), myelin oligodendrocyte glycoprotein (MOG) antibody-positive ON (MOG-ON), and AQP4 and MOG double-antibody-seronegative ON (D-ON). METHODS A single-center prospective study compared the logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) at most severe onset, 1 day before intravenous high-dose methylprednisolone (IVMP) treatment, 1 day before PE treatment, after five-cycles of PE therapy, and at 1-, 3-, and 6-month follow-up visits. The proportions of eyes in each visual outcome category were also compared. Logistic regression and a receiver operating characteristic curve were used to analyze predicted factors for VA improvement. RESULTS A total of 124 ON attacks of 122 patients were included. No significant differences were found in BCVA (P = 0.659) before and after PE therapy for 22 D-ON attacks, but VA improved in two of six MOG-ON patients. In 95 AQP4-ON patients suffering 96 attacks, the mean logMAR BCVA markedly improved and was steadily maintained after five-cycles of PE treatments (adjusted P < 0.001), with VA exhibiting a significantly increasing trend (adjusted P = 0.001) after PE treatment. The combination of the number of previous ON episodes and the time window to PE treatment showed accuracy of 74.7% for predicting an improvement in BCVA score ≥ 2 levels. In addition, a combination of logMAR VA before PE and the time window to PE treatment resulted in 83.4% accuracy in predicting whether VA would regain 1.0 logMAR. CONCLUSION PE therapy effectively improves visual outcomes for AQP4-ON patients, but offers limited value for D-ON patients. Early initiation greatly increases likelihood of achieving VA improvement.
Collapse
Affiliation(s)
- Junxia Fu
- The Chinese People's Liberation Army Medical School, Beijing, China.,Department of Ophthalmology, The Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yongping Wang
- The Chinese People's Liberation Army Medical School, Beijing, China.,Department of Ophthalmology, The Chinese People's Liberation Army General Hospital, Beijing, China
| | - Hongen Li
- Senior Department of Ophthalmology, The Third Medical Center of PLA General Hospital, Beijing, China
| | - Huanfen Zhou
- Department of Ophthalmology, The Chinese People's Liberation Army General Hospital, Beijing, China
| | - Honglu Song
- Senior Department of Ophthalmology, The Third Medical Center of PLA General Hospital, Beijing, China.,Department of Ophthalmology, The 980th Hospital of the Chinese PLA Joint Logistics Support Force, Shijiazhuang, Hebei, China
| | - Mingming Sun
- Senior Department of Ophthalmology, The Third Medical Center of PLA General Hospital, Beijing, China
| | - Quangang Xu
- Senior Department of Ophthalmology, The Third Medical Center of PLA General Hospital, Beijing, China
| | - Shaoying Tan
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China. .,Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China. .,Center for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong, China.
| | - Shihui Wei
- The Chinese People's Liberation Army Medical School, Beijing, China. .,Department of Ophthalmology, The Chinese People's Liberation Army General Hospital, Beijing, China.
| |
Collapse
|
6
|
Foo R, Yau C, Singhal S, Tow S, Loo JL, Tan K, Milea D. Optic Neuritis in the Era of NMOSD and MOGAD: A Survey of Practice Patterns in Singapore. Asia Pac J Ophthalmol (Phila) 2022; 11:184-195. [PMID: 35533337 DOI: 10.1097/apo.0000000000000513] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE The Optic Neuritis Treatment Trial was a landmark study with implications worldwide. In the advent of antibody testing for neuromyelitis optica spectrum disease (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), emerging concepts, such as routine antibody testing and management, remain controversial, resulting mostly from studies in White populations. We evaluate the practice patterns of optic neuritis investigation and management by neuro-ophthalmologists and neurologists in Singapore. DESIGN 21-question online survey consisting of 4 clinical vignettes. METHODS The survey was sent to all Singapore Medical Council- registered ophthalmologists and neurologists who regularly manage patients with optic neuritis. RESULTS Forty-two recipients (17 formally trained neuro-ophthalmol-ogists [100% response rate] and 25 neurologists) responded. Participants opted for routine testing of anti-aquaporin-4 antibodies (88.1% in mild optic neuritis and 97.6% in severe optic neuritis). Anti-MOG antibodies were frequently obtained (76.2% in mild and 88.1% in severe optic neuritis). Plasmapheresis was rapidly initiated (85.7%) in cases of nonresponse to intravenous steroids, even before obtaining anti-aquaporin-4 or anti-MOG serology results. In both NMOSD and MOGAD, oral mycophenolate mofetil was the preferred option if chronic immunosuppression was necessary. Steroids were given for a longer duration and tapered more gradually than in idiopathic optic neuritis cases. CONCLUSIONS Serological testing for NMOSD and MOGAD is considered as a routine procedure in cases of optic neuritis in Singapore, possibly due to local epidemiological features of these conditions. Chronic oral immunosuppression is preferred for the long term, but further research is necessary to establish the efficacy and cost-effectiveness of these practices.
Collapse
Affiliation(s)
- Reuben Foo
- Department of Neuro-Ophthalmology, Singapore National Eye Centre, Singapore City, Singapore
| | - Christine Yau
- Department of Neuro-Ophthalmology, Singapore National Eye Centre, Singapore City, Singapore
| | - Shweta Singhal
- Department of Neuro-Ophthalmology, Singapore National Eye Centre, Singapore City, Singapore
- Singapore Eye Research Institute, Singapore City, Singapore
- Duke-NUS Medical School, Singapore City, Singapore
| | - Sharon Tow
- Department of Neuro-Ophthalmology, Singapore National Eye Centre, Singapore City, Singapore
- Duke-NUS Medical School, Singapore City, Singapore
| | - Jing-Liang Loo
- Department of Neuro-Ophthalmology, Singapore National Eye Centre, Singapore City, Singapore
- Singapore Eye Research Institute, Singapore City, Singapore
- National University Hospital, Singapore City, Singapore
| | - Kevin Tan
- Duke-NUS Medical School, Singapore City, Singapore
- Department of Neurology, National Neuroscience Institute, Singapore City, Singapore
| | - Dan Milea
- Department of Neuro-Ophthalmology, Singapore National Eye Centre, Singapore City, Singapore
- Singapore Eye Research Institute, Singapore City, Singapore
- Duke-NUS Medical School, Singapore City, Singapore
| |
Collapse
|
7
|
Zhang J, Fan A, Wei L, Wei S, Xie L, Li M, Zhang W, Liu Q, Yang K. Efficacy and safety of plasma exchange or immunoadsorption for the treatment of option neuritis in demyelinating diseases: A systematic review and meta-analysis. Eur J Ophthalmol 2021; 32:1857-1871. [PMID: 34918576 DOI: 10.1177/11206721211065218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND There are no systematic reviews yet that evaluated the effects of PE/IA in patients with optic neuritis (ON) in demyelinating diseases. A meta-analysis of available study is needed to further explore the value of plasma exchange (PE) or immunoadsorption (IA) in treating ON in demyelinating diseases. METHODS All relevant articles published on PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), VIP Database, Wanfang, Sinomed and ophthalmology professional websites were searched. Study characteristics, demographic characteristics, clinical features and outcome measures were extracted. Response rate, adverse events (AE) rate, serious adverse event (SAE) rate, the log of the minimum angle of resolution (logMAR), visual outcome scale (VOS) and expanded disability status scales (EDSS) were evaluated using a random-effects model. RESULTS 35 studies were included between 1985 and 2020, containing 1191 patients. The response rates of PE and IA in acute attack of ON were 68% and 82% respectively. LogMAR (-0.60 to - 1.42) and VOS (-1.10 to -1.82) had been significantly improved from within 1 month to more than 1 month after PE treatment. Besides, we found that logMAR improved 1.78, 0.95 and 0.38, respectively ,when the time from symptom onset to the first PE/IA was less than 21 days, 21-28 days, and more than 28 days. The pooled mean difference of EDSS was -1.14.Adverse effects rate in patients with PE or IA were 0.20 and 0.06, respectively. CONCLUSION The meta-analysis provided evidence that PE/IA treatment was an effective and safe intervention, and it is recommended that early initiation of PE/IA treatment is critical.
Collapse
Affiliation(s)
- Jianping Zhang
- Department of Ophthalmology, 74713Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Aifang Fan
- Department of Ophthalmology, 91589Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - Lili Wei
- Evidence Based Medicine Center, School of Basic Medical Sciences, 12426Lanzhou University, Lanzhou, Gansu, China
| | - Shihui Wei
- Department of Ophthalmology, 104607The Chinese People's Liberation Army General Hospital, Beijing, China
| | - Lindan Xie
- Department of Ophthalmology, 104607The Chinese People's Liberation Army General Hospital, Beijing, China
| | - Meixuan Li
- Evidence Based Medicine Center, School of Basic Medical Sciences, 12426Lanzhou University, Lanzhou, Gansu, China
| | - Wenfang Zhang
- Department of Ophthalmology, 74713Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Qin Liu
- Department of Ophthalmology, 91589Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - Kehu Yang
- Evidence Based Medicine Center, School of Basic Medical Sciences, 12426Lanzhou University, Lanzhou, Gansu, China
| |
Collapse
|
8
|
Gao C, Zhuo Z, Duan Y, Yao Y, Su L, Zhang X, Song T. Structural and Functional Alterations in Visual Pathway After Optic Neuritis in MOG Antibody Disease: A Comparative Study With AQP4 Seropositive NMOSD. Front Neurol 2021; 12:673472. [PMID: 34177778 PMCID: PMC8220215 DOI: 10.3389/fneur.2021.673472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 05/05/2021] [Indexed: 12/04/2022] Open
Abstract
Background: Optic neuritis (ON) is an important clinical manifestation of neuromyelitis optic spectrum disease (NMOSD). Myelin oligodendrocyte glycoprotein (MOG) antibody-related and aquaporin 4 (AQP4) antibody-related ON show different disease patterns. The aim of this study was to explore the differences in structure and function of the visual pathway in patients with ON associated with MOG and AQP4 antibodies. Methods: In this prospective study, we recruited 52 subjects at Beijing Tiantan Hospital, including 11 with MOG Ig+ ON (MOG-ON), 13 with AQP4 Ig+ ON (AQP4-ON), and 28 healthy controls (HCs). Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) of optic radiation (OR), primary visual cortex volume (V1), brain volume, and visual acuity (VA) were compared among groups. A multiple linear regression was used to explore associations between VA and predicted factors. In addition, we used optical coherence tomography (OCT) to examine thickness of the peripapillary retinal nerve fiber layer (pRNFL) and retinal ganglion cell complex (GCC) in a separate cohort consisting of 15 patients with ON (8 MOG-ON and 7 AQP4-ON) and 28 HCs. Results: Diffusion tensor imaging showed that the FA of OR was lower than controls in patients with AQP4-ON (p = 0.001) but not those with MOG-ON (p = 0.329) and was significantly different between the latter two groups (p = 0.005), while V1 was similar in patients with MOG-ON and AQP4-ON (p = 0.122), but was lower than controls in AQP4-ON (p = 0.002) but not those with MOG-ON (p = 0.210). The VA outcomes were better in MOG-ON than AQP4-ON, and linear regression analysis revealed that VA in MOG-ON and AQP4-ON was both predicted by the FA of OR (standard β = −0.467 and −0.521, p = 0.036 and 0.034). Both patients of MOG-ON and AQP4-ON showed neuroaxonal damage in the form of pRNFL and GCC thinning but showed no statistically significant difference (p = 0.556, 0.817). Conclusion: The structural integrity of OR in patients with MOG-ON, which is different from the imaging manifestations of AQP4-ON, may be a reason for the better visual outcomes of patients with MOG-ON.
Collapse
Affiliation(s)
- Chenyang Gao
- Center for Neuroinflammation, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhizheng Zhuo
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yunyun Duan
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yajun Yao
- Center for Neuroinflammation, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Lei Su
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Xinghu Zhang
- Center for Neuroinflammation, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tian Song
- Center for Neuroinflammation, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| |
Collapse
|