吉隆坡医院视神经炎的患病率、临床概况和视觉结果:马来西亚视角

Eeling Goh, Nurul Ain Masnon, L. Thavaratnam, Shanthi Viswanathan Shantakumar, Tajunisah Begam Bt Mohd Iqbal
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引用次数: 0

摘要

目的:研究马来西亚人群视神经炎(ON)患者的临床表现、视力结果以及复发和视力恢复不良的预测因素。研究设计:纵向随访的回顾性队列研究。方法:选取发病4周内符合视神经炎纳入标准的神经眼科门诊患者113例。该研究于2015年5月至2018年6月进行。人口统计资料、临床表现、眼科调查、血清学调查和影像学结果被记录并制成表格。患者随访1年,以评估视力结果和视网膜神经纤维层(RNFL)变薄的证据。通过多变量分析确定了复发和视力不良的显著相关因素。结果:患者年龄13 ~ 71岁。最常见的发病年龄为15-49岁(67.3%)。ON在马来人中占主导地位(65.5%),其次是华人(21.2%)和印度人(13.3%)。ON最常见的形式是神经脊髓炎视谱障碍(NMOSD),它影响所有种族。ON复发的重要预测因素是15-49岁年龄组的出现(p = 0.013)和治疗1年后RNFL变薄的存在(p = 0.001)。印度人的复发率明显较低,为0.063 (p = 0.015)。与视力差> 6/18相关的显著变量是视力差> 6/18 (p < 0.001)和治疗1年后RNFL变薄的证据(p = 0.003)。女性视力预后优于男性(p = 0.005)。结论:NMOSD是我们研究人群中最常见的ON形式。目前的年龄组为15-49岁,治疗1年内出现RNFL变薄与复发显著相关。此外,RNFL变薄和视力差> 6/18的证据与视力差有关。这组患者需要定期监测并尽早获得治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The prevalence, clinical profile, and visual outcome of optic neuritis in Hospital Kuala Lumpur: a Malaysian perspective
Purpose: To study the clinical presentation, visual outcome, and predictors for both recurrence and poor visual recovery among optic neuritis (ON) patients in the Malaysian population.Study design: Retrospective cohort study with longitudinal follow-up.Methods: A total of 113 patients from the neuro-ophthalmology clinic fulfilling optic neuritis inclusion criteria within 4 weeks of onset were included. The study was conducted from May 2015 to June 2018. Demographic data, clinical findings, ophthalmological investigation, serological investigation, and imaging results were documented and tabulated. Patients were followed up to 1 year to assess the visual outcome and evidence of retinal nerve fibre layer (RNFL) thinning. Significant associative factors for recurrence and poor visual outcomes were identified using multivariate analysis.Results: The age of the patients ranged from 13 to 71 years of age. The commonest age of presentation was 15–49 (67.3%) years of age. ON was predominant among Malays (65.5%), followed by Chinese (21.2%), and Indians (13.3%). The commonest form of ON was neuromyelitis optica spectrum disorder (NMOSD), which affected all ethnicities. Significant predictors for recurrence of ON were presentation within the 15–49 age group (p = 0.013) and presence of RNFL thinning following 1 year of treatment (p = 0.001). Indians had significantly lower odds of recurrence, 0.063 (p = 0.015). Significant variables associated with poor visual outcome > 6/18 were poor presenting vision > 6/18 (p < 0.001) and evidence of RNFL thinning following 1 year of treatment (p = 0.003). Females had better visual prognosis (p = 0.005) than males.Conclusion: NMOSD was the commonest form of ON in our study population. The presenting age group of 15–49 along with the presence of RNFL thinning within 1 year of treatment were significantly associated with recurrence. Additionally, evidence of RNFL thinning and poor presenting vision > 6/18 were associated with a poor visual outcome. This group of patients will require regular monitoring and early access to treatment.
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