Application of the international criteria for optic neuritis in the Acute Optic Neuritis Network

IF 4.4 2区医学 Q1 CLINICAL NEUROLOGY

Annals of Clinical and Translational Neurology Pub Date : 2024-08-04 DOI:10.1002/acn3.52166

Philipp Klyscz, Susanna Asseyer, Ricardo Alonso, Charlotte Bereuter, Omer Bialer, Atira Bick, Sara Carta, John J. Chen, Leila Cohen, Yamit Cohen-Tayar, Edgar Carnero Contentti, Russell C. Dale, Eoin P. Flanagan, Jonathan A. Gernert, Julian Haas, Joachim Havla, Christoph Heesen, Mark Hellmann, Netta Levin, Pablo Lopez, Itay Lotan, Maria Belen Luis, Sara Mariotto, Christina Mayer, Alvaro Jose Mejia Vergara, Cassandra Ocampo, Susana Ochoa, Frederike C. Oertel, Maja Olszewska, José Luis Peralta Uribe, Jaume Sastre-Garriga, Dario Scocco, Sudarshini Ramanathan, Natthapon Rattanathamsakul, Fu-Dong Shi, Jemal Shifa, Ilya Simantov, Sasitorn Siritho, Alon Tiosano, Nanthaya Tisavipat, Isabel Torres, Adi Vaknin Dembinsky, Angela Vidal-Jordana, Adi Wilf-Yarkoni, Ti Wu, Sol Zamir, Luis Alfonso Zarco, Hanna G. Zimmermann, Axel Petzold, Friedemann Paul, Hadas Stiebel-Kalish

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引用次数: 0

Abstract

Objective

The first international consensus criteria for optic neuritis (ICON) were published in 2022. We applied these criteria to a prospective, global observational study of acute optic neuritis (ON).

Methods

We included 160 patients with a first-ever acute ON suggestive of a demyelinating CNS disease from the Acute Optic Neuritis Network (ACON). We applied the 2022 ICON to all participants and subsequently adjusted the ICON by replacing a missing relative afferent pupillary defect (RAPD) or dyschromatopsia if magnetic resonance imaging pathology of the optical nerve plus optical coherence tomography abnormalities or certain biomarkers are present.

Results

According to the 2022 ICON, 80 (50%) patients were classified as definite ON, 12 (7%) patients were classified as possible ON, and 68 (43%) as not ON (NON). The main reasons for classification as NON were absent RAPD (52 patients, 76%) or dyschromatopsia (49 patients, 72%). Distribution of underlying ON etiologies was as follows: 78 (49%) patients had a single isolated ON, 41 (26%) patients were diagnosed with multiple sclerosis, 25 (16%) patients with myelin oligodendrocyte glycoprotein antibody-associated disease, and 15 (9%) with neuromyelitis optica spectrum disorder. The application of the adjusted ON criteria yielded a higher proportion of patients classified as ON (126 patients, 79%).

Interpretation

According to the 2022 ICON, almost half of the included patients in ACON did not fulfill the requirements for classification of definite or possible ON, particularly due to missing RAPD and dyschromatopsia. Thorough RAPD examination and formal color vision testing are critical to the application of the 2022 ICON.

Abstract Image

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在急性视神经炎网络中应用视神经炎国际标准。

目的：2022 年发布了首个视神经炎（ICON）国际共识标准。我们将这些标准应用于一项关于急性视神经炎（ON）的前瞻性全球观察研究：我们从急性视神经炎网络（ACON）中纳入了 160 名首次患急性视神经炎并提示患有脱髓鞘性中枢神经系统疾病的患者。我们对所有参与者应用了2022年ICON，随后对ICON进行了调整，如果存在视神经磁共振成像病理学、光学相干断层扫描异常或某些生物标志物，则替换缺失的相对传入性瞳孔缺损（RAPD）或色觉障碍：根据 2022 ICON，80 例（50%）患者被归类为明确的视神经缺损，12 例（7%）患者被归类为可能的视神经缺损，68 例（43%）患者被归类为非视神经缺损（NON）。被归类为非ON的主要原因是RAPD缺失（52名患者，76%）或色觉障碍（49名患者，72%）。潜在 ON 病因的分布情况如下：78名患者（49%）有单个孤立的ON，41名患者（26%）被诊断为多发性硬化症，25名患者（16%）患有髓鞘少突胶质细胞糖蛋白抗体相关疾病，15名患者（9%）患有神经脊髓炎视神经频谱紊乱。应用调整后的ON标准，被归类为ON的患者比例更高（126例，79%）：根据2022年的ICON，ACON中几乎一半的患者不符合明确或可能的ON分类要求，特别是由于RAPD缺失和色觉异常。彻底的 RAPD 检查和正规的色觉测试对于 2022 ICON 的应用至关重要。

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来源期刊

Annals of Clinical and Translational Neurology Medicine-Neurology (clinical)

CiteScore

9.10

自引率

1.90%

发文量

218

审稿时长

8 weeks

期刊介绍： Annals of Clinical and Translational Neurology is a peer-reviewed journal for rapid dissemination of high-quality research related to all areas of neurology. The journal publishes original research and scholarly reviews focused on the mechanisms and treatments of diseases of the nervous system; high-impact topics in neurologic education; and other topics of interest to the clinical neuroscience community.