Prospective longitudinal study on prognostic factors of visual recovery and structural change after a first episode of optic neuritis.


Journal

European journal of neurology
ISSN: 1468-1331
Titre abrégé: Eur J Neurol
Pays: England
ID NLM: 9506311

Informations de publication

Date de publication:
09 2022
Historique:
received: 02 03 2022
accepted: 18 05 2022
pubmed: 27 5 2022
medline: 9 8 2022
entrez: 26 5 2022
Statut: ppublish

Résumé

This study was undertaken to determine the role of optical coherence tomography (OCT) in predicting the final visual and structural outcome, and to evaluate the correlation between functional eye outcome and retinal changes, in patients with a first episode of optic neuritis (ON). In this prospective study, consecutive adult patients with acute ON underwent ophthalmological evaluation at baseline and at 1 and 12 months, including OCT measurements of peripapillary retinal nerve fiber layer (pRNFL), macular ganglion cell and inner plexiform layer, and inner nuclear layer thicknesses; high- and low-contrast visual acuity; visual field assessment; and baseline brain magnetic resonance imaging. Univariate and multivariate linear regressions were used to assess predictive factors of outcome. Correlations between 12-month visual function and retinal structure were estimated by Spearman coefficients. Two groups of patients were analyzed, with or without multiple sclerosis (MS). Among 116 patients, 79 (68.1%) had MS, and 37 (31.9%) had ON not related to MS (including 19 idiopathic [i.e., isolated] ON, and 13 and five with myelin oligodendrocyte glycoprotein and aquaporin-4 antibodies, respectively). We found no independent predictive factor of visual and retinal outcome. Analysis of the relationship between the visual field test (mean deviation) and pRNFL thickness demonstrated a threshold of 75.4 μm and 66.4 μm, below which the mean deviation was worse, for patients with MS (p = 0.007) and without MS (p < 0.001), respectively. We found that inner retinal layer measurements during the first month are not predictive of final outcome. The critical threshold of axonal integrity, below which visual function is damaged, is different between patients with and without MS.

Sections du résumé

BACKGROUND AND PURPOSE
This study was undertaken to determine the role of optical coherence tomography (OCT) in predicting the final visual and structural outcome, and to evaluate the correlation between functional eye outcome and retinal changes, in patients with a first episode of optic neuritis (ON).
METHODS
In this prospective study, consecutive adult patients with acute ON underwent ophthalmological evaluation at baseline and at 1 and 12 months, including OCT measurements of peripapillary retinal nerve fiber layer (pRNFL), macular ganglion cell and inner plexiform layer, and inner nuclear layer thicknesses; high- and low-contrast visual acuity; visual field assessment; and baseline brain magnetic resonance imaging. Univariate and multivariate linear regressions were used to assess predictive factors of outcome. Correlations between 12-month visual function and retinal structure were estimated by Spearman coefficients. Two groups of patients were analyzed, with or without multiple sclerosis (MS).
RESULTS
Among 116 patients, 79 (68.1%) had MS, and 37 (31.9%) had ON not related to MS (including 19 idiopathic [i.e., isolated] ON, and 13 and five with myelin oligodendrocyte glycoprotein and aquaporin-4 antibodies, respectively). We found no independent predictive factor of visual and retinal outcome. Analysis of the relationship between the visual field test (mean deviation) and pRNFL thickness demonstrated a threshold of 75.4 μm and 66.4 μm, below which the mean deviation was worse, for patients with MS (p = 0.007) and without MS (p < 0.001), respectively.
CONCLUSIONS
We found that inner retinal layer measurements during the first month are not predictive of final outcome. The critical threshold of axonal integrity, below which visual function is damaged, is different between patients with and without MS.

Identifiants

pubmed: 35617154
doi: 10.1111/ene.15420
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2781-2791

Informations de copyright

© 2022 European Academy of Neurology.

Références

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Auteurs

Romain Deschamps (R)

Department of Neurology, Adolphe de Rothschild Foundation Hospital, Paris, France.

Natalia Shor (N)

Department of Radiology, Adolphe de Rothschild Foundation Hospital, Paris, France.
Department of Neuroradiology, Public Hospitals of Paris, La Pitié Salpêtrière University Hospitals, Sorbonne University, Paris, France.

Catherine Vignal (C)

Department of Neuro-Ophthalmology, Adolphe de Rothschild Foundation Hospital, Paris, France.

Jessica Guillaume (J)

Clinical Research Department, Adolphe de Rothschild Foundation Hospital, Paris, France.

Marine Boudot de la Motte (M)

Department of Neurology, Adolphe de Rothschild Foundation Hospital, Paris, France.

Flore Salviat (F)

Clinical Research Department, Adolphe de Rothschild Foundation Hospital, Paris, France.

Augustin Lecler (A)

Department of Radiology, Adolphe de Rothschild Foundation Hospital, Paris, France.

Romain Marignier (R)

Department of Neurology and Reference Center for Rare Inflammatory Diseases of the Brain and Spinal Cord, Civil Hospices of Lyon, Pierre Wertheimer Neurological Hospital, Lyon/Bron, France.

Rabih Hage (R)

Department of Neuro-Ophthalmology, Adolphe de Rothschild Foundation Hospital, Paris, France.

Sarah Coulette (S)

Department of Neurology, Adolphe de Rothschild Foundation Hospital, Paris, France.

Samuel Bidot (S)

Department of Neuro-Ophthalmology, Adolphe de Rothschild Foundation Hospital, Paris, France.

Antoine Gueguen (A)

Department of Neurology, Adolphe de Rothschild Foundation Hospital, Paris, France.

Martine Mauget-Faysse (M)

Clinical Research Department, Adolphe de Rothschild Foundation Hospital, Paris, France.

Caroline Bensa (C)

Department of Neurology, Adolphe de Rothschild Foundation Hospital, Paris, France.

Vivien Vasseur (V)

Clinical Research Department, Adolphe de Rothschild Foundation Hospital, Paris, France.

Olivier Gout (O)

Department of Neurology, Adolphe de Rothschild Foundation Hospital, Paris, France.

Cedric Lamirel (C)

Department of Neuro-Ophthalmology, Adolphe de Rothschild Foundation Hospital, Paris, France.

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