Clinical profile and challenges faced in the management of optic neuritis: the Indian scenario.
AQP4-IgG-associated optic neuritis
Atypical optic neuritis
Double seronegative optic neuritis
MOG-IgG-associated optic neuritis
Neuromyelitis optica spectrum disorder
Optic neuritis
Journal
International ophthalmology
ISSN: 1573-2630
Titre abrégé: Int Ophthalmol
Pays: Netherlands
ID NLM: 7904294
Informations de publication
Date de publication:
15 Mar 2024
15 Mar 2024
Historique:
received:
29
06
2023
accepted:
23
02
2024
medline:
18
3
2024
pubmed:
15
3
2024
entrez:
15
3
2024
Statut:
epublish
Résumé
Optic neuritis (ON) is a relatively common ophthalmic disease that has recently received renewed attention owing to immunological breakthroughs. We studied the profile of patients with ON with special reference to antibody-mediated ON and the challenges faced in its management. Case records of patients with ON presenting to a tertiary eye-care center in South India were analyzed. Data on demographics, presenting visual acuity (VA), clinical features, seropositivity for aquaporin-4 immunoglobulin G (AQP4-IgG) and myelin oligodendrocyte glycoprotein immunoglobulin G (MOG-IgG), details of magnetic resonance imaging (MRI) of orbits and brain, and treatment were collected. Among 138 cases with acute ON, male: female ratio was 1:2. Isolated ON was present in 41.3% of cases. Antibody testing of sera was performed in 68 patients only due to financial limitations. Among these, 48.5% were MOG-IgG-seropositive, 11.76% were AQP4-IgG-seropositive, and 30.88% samples were double seronegative. Other causes included multiple sclerosis (n = 4), lactational ON (n = 4), tuberculosis (n = 2), invasive perineuritis (n = 2), COVID-19 vaccination (n = 2), and COVID-19 (n = 1). The mean presenting best corrected visual acuity (BCVA) was 1.31 ± 1.16 logMAR (logarithm of the minimum angle of resolution). The mean BCVA at 3 months was 0.167 ± 0.46 logMAR. Only initial VA ≤ 'Counting fingers' (CF) had a significant association with the visual outcome for final VA worse than CF. The steep cost of investigations and treatment posed challenges for many patients in the management of ON. MOG-IgG-associated ON is common in India. Unfortunately, financial constraints delay the diagnosis and timely management of ON, adversely affecting the outcome.
Identifiants
pubmed: 38488890
doi: 10.1007/s10792-024-03081-1
pii: 10.1007/s10792-024-03081-1
doi:
Substances chimiques
COVID-19 Vaccines
0
Autoantibodies
0
Aquaporin 4
0
Immunoglobulin G
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
138Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer Nature B.V.
Références
Lennon VA, Wingerchuk DM, Kryzer TJ et al (2004) A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis. Lancet 364:2106–2112. https://doi.org/10.1016/S0140-6736(04)17551-X
doi: 10.1016/S0140-6736(04)17551-X
pubmed: 15589308
Waters P, Woodhall M, O’Connor KC et al (2015) MOG cell-based assay detects non-MS patients with inflammatory neurologic disease. Neurol Neuroimmunol Neuroinflamm 2:e89. https://doi.org/10.1212/NXI.0000000000000089
doi: 10.1212/NXI.0000000000000089
pubmed: 25821844
pmcid: 4370386
Beck RW, Cleary PA (1993) Optic neuritis treatment trial: one-year follow-up results. Arch Ophthalmol 111:773–775. https://doi.org/10.1001/archopht.1993.01090060061023
doi: 10.1001/archopht.1993.01090060061023
pubmed: 8512477
Saxena R, Phuljhele S, Menon V, Gadaginamath S, Sinha A, Sharma P (2014) Clinical profile and short-term outcomes of optic neuritis patients in India. Indian J Ophthalmol 62:265–267. https://doi.org/10.4103/0301-4738.121131
doi: 10.4103/0301-4738.121131
pubmed: 24722269
pmcid: 4061659
Pandit L, Shetty R, Misri Z et al (2012) Optic neuritis: experience from a south Indian demyelinating disease registry. Neurol India 60:470–475. https://doi.org/10.4103/0028-3886.103186
doi: 10.4103/0028-3886.103186
pubmed: 23135022
Ambika S, Durgapriyadarshini S, Padmalakshmi K, Noronha V, Arjundas D (2022) Clinical profile, imaging features and short-term visual outcomes of Indian optic neuritis patients with and without seromarkers for myelin oligodendrocyte glycoprotein and neuromyelitis optica. Indian J Ophthalmol 70(1):194–200. https://doi.org/10.4103/ijo.IJO_887_21
doi: 10.4103/ijo.IJO_887_21
pubmed: 34937238
Lyttle DP, Johnson LN, Margolin EA, Madsen RW (2016) Levodopa as a possible treatment of visual loss in nonarteritic anterior ischemic optic neuropathy. Graefes Arch Clin Exp Ophthalmol 254(4):757–764. https://doi.org/10.1007/s00417-015-3191-z
doi: 10.1007/s00417-015-3191-z
pubmed: 26483145
Wingerchuk DM, Banwell B, Bennett JL et al (2015) International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology 85(2):177–189. https://doi.org/10.1212/WNL.0000000000001729
doi: 10.1212/WNL.0000000000001729
pubmed: 26092914
pmcid: 4515040
López-Chiriboga AS, Majed M, Fryer J et al (2018) Association of MOG-IgG serostatus with relapse after acute disseminated encephalomyelitis and proposed diagnostic criteria for MOG-IgG-associated disorders. JAMA Neurol 75(11):1355–1363. https://doi.org/10.1001/jamaneurol.2018.1814
doi: 10.1001/jamaneurol.2018.1814
pubmed: 30014148
pmcid: 6248120
Thompson AJ, Banwell BL, Barkhof F et al (2018) Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol 17(2):162–173. https://doi.org/10.1016/S1474-4422(17)30470-2
doi: 10.1016/S1474-4422(17)30470-2
pubmed: 29275977
Pandit L, Kundapur R (2014) Prevalence and patterns of demyelinating central nervous system disorders in urban Mangalore, South India. Mult Scler 20:1651–1653. https://doi.org/10.1177/1352458514521503
doi: 10.1177/1352458514521503
pubmed: 24493471
Ambika S, Balasubramanian M, Theresa L, Veeraputhiran A, Arjundas D (2015) Aquaporin 4 antibody [NMO Ab] status in patients with severe optic neuritis in India. Int Ophthalmol 35:801–806. https://doi.org/10.1007/s10792-015-0048-8
doi: 10.1007/s10792-015-0048-8
pubmed: 25682013
Jeslin J, Seetharaman C, Shah VM (2021) Optic neuritis during lactation: a case series. J Hum Lact 37(3):577–580. https://doi.org/10.1177/0890334420970496
doi: 10.1177/0890334420970496
pubmed: 33201757
Woung LC, Lin CH, Tsai CY, Tsai MT, Jou JR, Chou P (2007) Optic neuritis among national health insurance enrollees in Taiwan, 2000–2004. Neuroepidemiology 29:250–254. https://doi.org/10.1159/000112858
doi: 10.1159/000112858
pubmed: 18176082
Lim SA, Goh KY, Tow S et al (2008) Optic neuritis in Singapore. Singapore Med J 49:667–671
pubmed: 18830538
Filippatou AG, Mukharesh L, Saidha S, Calabresi PA, Sotirchos ES (2020) AQP4-IgG and MOG-IgG related optic neuritis-prevalence, optical coherence tomography findings, and visual outcomes: a systematic review and meta-analysis. Front Neurol 11:540156. https://doi.org/10.3389/fneur.2020.540156
doi: 10.3389/fneur.2020.540156
pubmed: 33132999
pmcid: 7578376
Ishikawa H, Kezuka T, Shikishima K et al (2019) Epidemiologic and clinical characteristics of optic neuritis in Japan. Ophthalmology 126(10):1385–1398. https://doi.org/10.1016/j.ophtha.2019.04.042
doi: 10.1016/j.ophtha.2019.04.042
pubmed: 31196727
Jitprapaikulsan J, Chen JJ, Flanagan EP et al (2018) Aquaporin-4 and myelin oligodendrocyte glycoprotein autoantibody status predict outcome of recurrent optic neuritis. Ophthalmology 125:1628–1637. https://doi.org/10.1016/j.ophtha.2018.03.041
doi: 10.1016/j.ophtha.2018.03.041
pubmed: 29716788
Hassan MB, Stern C, Flanagan EP et al (2020) Population-based incidence of optic neuritis in the era of aquaporin-4 and myelin oligodendrocyte glycoprotein antibodies. Am J Ophthalmol 220:110–114. https://doi.org/10.1016/j.ajo.2020.07.014
doi: 10.1016/j.ajo.2020.07.014
pubmed: 32707199
pmcid: 8491771
de Mol CL, Wong Y, van Pelt ED et al (2020) The clinical spectrum and incidence of anti-MOG-associated acquired demyelinating syndromes in children and adults. Mult Scler 26:806–814. https://doi.org/10.1177/1352458519845112
doi: 10.1177/1352458519845112
pubmed: 31094288
Chen JJ, Flanagan EP, Jitprapaikulsan J et al (2018) Myelin oligodendrocyte glycoprotein antibody-positive optic neuritis: clinical characteristics, radiologic clues, and outcome. Am J Ophthalmol 195:8–15. https://doi.org/10.1016/j.ajo.2018.07.020
doi: 10.1016/j.ajo.2018.07.020
pubmed: 30055153
pmcid: 6371779
Hansapinyo L, Vivattanaseth C (2018) Clinical characteristics, treatment outcomes and predictive factors in optic neuritis. Open Ophthalmol J 12:247–255. https://doi.org/10.2174/1874364101812010247
doi: 10.2174/1874364101812010247
pubmed: 30258505
pmcid: 6131319