Neuroophthalmological evaluation in primary inflammatory demyelinating diseases with special reference to optic neuritis: A prospective study.

IF 1 Q4 PRIMARY HEALTH CARE
Ankit Khetan, Rajesh Verma, Rajarshi Chakraborty, Ravindra Kumar Garg, Hardeep Singh Malhotra, Praveen Kumar Sharma, Neeraj Kumar, Ravi Uniyal, Shweta Pandey, Imran Rizvi
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引用次数: 0

Abstract

Introduction: The involvement of ocular system especially optic neuritis (ON) is an important clinical aspect of inflammatory demyelinating disease (IDD) of the central nervous system. The primary IDD spectrum includes neuromyelitis optica spectrum disorders (NMOSD), myelin oligodendrocyte glycoprotein-associated diseases (MOGAD), multiple sclerosis (MS), and clinically isolated syndrome (CIS). The clinical presentation of ON varies according to disease pathophysiology.

Aim: We aimed to determine the clinical characteristics of treatment-naïve ON at baseline and on the 6-month follow-up and assessed the predictors of visual outcome.

Methods: A prospective study of patients with treatment-naïve ON was performed with structural and functional ophthalmological evaluation. Univariate and multivariate logistic regression analyses were used to determine the predictive factors of visual outcome.

Results: Out of 46 patients of IDD, ON occurred in 30 patients. The etiological subtyping included NMOSD (10), CIS (8), MOGAD (7), and MS (5) patients in our study. The ON group showed female preponderance, greater delay in diagnosis, and significant relapsing course. Bilaterality occurred predominantly in NMOSD followed by MOGAD. Optical coherence tomography analysis showed predominant thinning of superior and inferior quadrants in retinal nerve fiber layer (RNFL) and global thinning of Ganglion cell inner plexiform layer (GC-IPL) in NMOSD, but the values were not statistically significant. Univariate analysis for predictors of visual outcome showed age at onset, delay in diagnosis, NMOSD, longitudinally extensive ON (LEON) and chiasmal lesions were associated with poor outcome, while multivariate analysis showed statistical association of NMOSD and LEON with poor outcome.

Conclusion: NMOSD and longitudinally extensive optic neuritis showed poor ophthalmological outcome and optical coherence tomography was unyielding.

Abstract Image

Abstract Image

神经眼科学评价原发性炎性脱髓鞘疾病,特别是视神经炎:一项前瞻性研究。
摘要:眼系统特别是视神经炎(ON)的累及是中枢神经系统炎症性脱髓鞘病(IDD)的一个重要临床表现。原发性IDD包括视神经脊髓炎谱系障碍(NMOSD)、髓鞘少突胶质细胞糖蛋白相关疾病(MOGAD)、多发性硬化症(MS)和临床孤立综合征(CIS)。ON的临床表现因疾病病理生理而异。目的:我们旨在确定treatment-naïve ON在基线和6个月随访时的临床特征,并评估视力结果的预测因素。方法:对treatment-naïve ON患者进行前瞻性研究,并进行结构和功能眼科评价。采用单因素和多因素logistic回归分析确定视觉结果的预测因素。结果:46例IDD患者中,有30例发生ON。病因分型包括NMOSD(10例)、CIS(8例)、MOGAD(7例)和MS(5例)。ON组以女性为主,诊断延迟较大,复发期明显。双侧性主要发生在NMOSD,其次是MOGAD。光学相干断层扫描分析显示,NMOSD患者视网膜神经纤维层(RNFL)上下象限明显变薄,神经节细胞内丛状层(GC-IPL)整体变薄,但差异无统计学意义。单因素分析显示,发病年龄、诊断延迟、NMOSD、纵向广泛ON (LEON)和交叉病变与预后不良相关,多因素分析显示NMOSD和LEON与预后不良有统计学相关性。结论:NMOSD和纵向广泛性视神经炎表现为较差的眼科预后,光学相干断层扫描表现不佳。
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自引率
7.10%
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884
审稿时长
40 weeks
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