Radiomics Analysis of DTI Data to Assess Vision Outcome After Intravenous Methylprednisolone Therapy in Neuromyelitis Optic Neuritis

2018 ◽  
Vol 49 (5) ◽  
pp. 1365-1373 ◽  
Author(s):  
Yuan Tian ◽  
Zhenyu Liu ◽  
Zhenchao Tang ◽  
Mingge Li ◽  
Xin Lou ◽  
...  
Keyword(s):  
Optic Neuritis ◽  
Intravenous Methylprednisolone

scholarly journals Factors influencing intravenous methylprednisolone pulse therapy in Chinese patients with isolated optic neuritis associated with AQP4 antibody-seropositive neuromyelitis optica

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sitong Guo ◽  
Hanqiu Jiang ◽  
Libin Jiang ◽  
Jingting Peng ◽  
Hongjuan Liu ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Optic Neuritis ◽  
Neuromyelitis Optica ◽  
Age At Onset ◽  
Chinese Patients ◽  
Intravenous Methylprednisolone ◽  
Methylprednisolone Pulse ◽  
Factors Influencing ◽  
Intravenous Methylprednisolone Pulse ◽  
Aqp4 Antibody

AbstractThis study investigated the factors influencing intravenous methylprednisolone pulse (IVMP) therapy for recovering visual acuity in Chinese patients with aquaporin-4 (AQP4) antibody-seropositive neuromyelitis optica-related optic neuritis (NMO-ON). This retrospective case series included 243 affected eyes of 182 patients (36 male, 146 female) diagnosed with NMO-ON in the Neuro-Ophthalmology Clinic of Beijing Tongren Hospital from September 2012 to September 2020. All patients with AQP4-antibody seropositivity had clinical manifestations of acute ON, excluding other diagnoses and received IVMP treatment at 500 mg/day or 1000 mg/day for 3 days. Primary outcome was the extent of improvement in logMAR visual acuity after IVMP treatment. The therapeutic influences of sex, age, baseline visual acuity, therapeutic intervals, and IVMP dose on acute NMO-ON were analysed. Chi-square tests, Mann–Whitney U-tests, Kruskal–Wallis tests, Spearman’s correlation coefficients, and multiple linear regression were used for statistical analysis. Age ranged between 7 and 80 years (median age, 44; interquartile range [IQR], 29–52) years. Among the 243 eyes, the median improvement in logMAR visual acuity was 0.3 (IQR, 0–0.9). Therapeutic efficacy of IVMP was significantly higher in female than in male patients (Z = 2.117, P = 0.034). The treatment effect gradually decreased with increase in age at onset (Rs = 0.157, P = 0.015), and visual improvement was significantly lower in patients aged > 50 years than in those ≤ 50 years (Z = 2.571, P = 0.010). When patients had low visual acuity at onset, improvements were more obvious (rho =  − 0.317, P < 0.001); however, final visual acuity was still low (rho = 0.688, P < 0.001). Therapeutic effect was negatively correlated with therapeutic intervals (rho = 0.228, P = 0.001). Dosage of methylprednisolone (1000 mg/day or 500 mg/day) did not significantly influence treatment efficacy (Z = 0.951 P = 0.342). Therefore, IVMP therapy can improve visual acuity in the affected eyes of patients with AQP4 antibody-seropositive NMO-ON with similar effect at 500 mg/day and 1000 mg/day doses. Sex, age at onset, and therapeutic intervals may influence the efficacy of IVMP in patients with NMO-ON.

A Woman With Subacute Painful Vision Loss

2021 ◽  
pp. 3-6
Author(s):  
Jiraporn Jitprapaikulsan ◽  
M. Tariq Bhatti ◽  
Eric R. Eggenberger ◽  
Marie D. Acierno ◽  
John J. Chen
Keyword(s):  
Optic Neuritis ◽  
Eye Movement ◽  
Immunoglobulin G ◽  
Vision Loss ◽  
Visual Fields ◽  
Corticosteroid Treatment ◽  
Antineutrophil Cytoplasmic Antibody ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Intravenous Methylprednisolone ◽  
Eye Pain

A 51-year-old White woman sought care for vision loss 1 week after a nonspecific upper respiratory tract infection. She reported pain in both eyes exacerbated by eye movement, which lasted for several days, followed by bilateral vision loss to the level of counting fingers–only vision. Optic neuritis was diagnosed, and she was treated with 1 g intravenous methylprednisolone for 3 days. Her vision improved substantially, and the pain resolved during the corticosteroid treatment. However, 1 week later, she woke up with right eye pain and vision loss. She was again treated with 5 days of intravenous methylprednisolone, with visual improvement nearly back to baseline. Two weeks later, she had recurrence of painful vision loss in both eyes. A diagnosis of chronic relapsing inflammatory optic neuropathy was made. Tests for serum angiotensin-converting enzyme, antineutrophil cytoplasmic antibody, antinuclear antibody, Lyme disease, syphilis, tuberculosis, and aquaporin-4-immunoglobulin G antibodies were negative. Serum was definitively positive for myelin oligodendrocyte glycoprotein-immunoglobulin G antibodies at a titer of 1:1,000. Myelin oligodendrocyte glycoprotein-immunoglobulin G–associated recurrent optic neuritis was diagnosed. After her diagnosis of recurrent corticosteroid-dependent optic neuritis associated with myelin oligodendrocyte glycoprotein-immunoglobulin G positivity, the patient was treated with 5 days of intravenous methylprednisolone. The eye pain resolved, and her vision returned to normal. At follow-up evaluation, the patient’s visual acuity, color vision, and visual fields were normal in both eyes, but there was mild bilateral optic disc pallor. She has not had recurrent demyelinating episodes while on chronic immunotherapy. Optic neuritis is an inflammatory demyelination of the optic nerve manifesting as acute to subacute vision loss, classically associated with pain with eye movement. The long-term prevention and prognosis depend on the cause of the optic neuritis.

scholarly journals Unusual increase in the incidence of unilateral Optic Neuritis: Case presentation

2021 ◽  
pp. 044-048
Author(s):  
Cáceres-Toledo Odalys ◽  
Cáceres-Toledo María ◽  
Zhao Runse ◽  
Laurencio Yeimi Carolina ◽  
O-Lozano Yarlín La ◽  
...  
Keyword(s):  
Optic Neuritis ◽  
Cell Damage ◽  
Signs And Symptoms ◽  
Intravenous Methylprednisolone ◽  
Fiber Layer ◽  
Viral Origin ◽  
Case Presentation ◽  
General Signs ◽  
Epidemiological Characteristics ◽  
Unusual Increase

Optic neuritis presents as an acute or subacute inflammatory episode. Objective: Describe the clinical-epidemiological characteristics in 7 cases with unilateral optic neuritis and evaluate the therapeutic results obtained. Material and method: A series of cases with a diagnosis of unilateral optic neuritis who attended the Neurophthalmology consultation at the Hermanos Ameijeiras Hospital in Havana, Cuba, from August 6 to November 16, 2018, from Havana and Matanzas, were studied. An unusual increase in the incidence of NO was recorded in the period analyzed. Results: An unusual increase in the incidence of unilateral optic neuritis was recorded. The average age was 33.5 years. All reported unilateral painless visual loss. Four patients reported general signs and symptoms suggestive of having suffered a respiratory disease of viral origin, between 7 and 15 days before optic neuritis. In the examination carried out, great impairment of visual acuity (≤0.05) and colors (0/21) was found. The centro-caecal scotoma was the most frequent campimetric defect. Optical Coherence Tomography (OCT) in the affected eye showed increased neuroretinal thickness, decreased nerve fiber layer, and ganglion cell damage. Treatment was with intravenous methylprednisolone and B vitamins. Conclusions: An unusual increase in patients with unilateral optic neuritis was observed. The OCT revealed damage to the structures at the level of the retina and the optic nerve. The therapeutic effectiveness was conditioned by the time of evolution of the neuritis.

First Clinical Experience with Anti-myelin Oligodendrocyte Glycoprotein Antibody-Positive Optic Neuritis

2020 ◽  
Vol 237 (04) ◽  
pp. 458-463 ◽  
Author(s):  
Jan Heckmann ◽  
Margarita Todorova ◽  
Stefanie Müller ◽  
Philip Julian Broser ◽  
Veit Sturm
Keyword(s):  
Visual Acuity ◽  
Optic Neuritis ◽  
Pulse Therapy ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Individual Treatment ◽  
Igg Antibodies ◽  
Intravenous Methylprednisolone ◽  
Finger Counting ◽  
The Right

Abstract Background Antibodies against myelin oligodendrocyte glycoprotein (MOG-IgG) have been consistently found in a range of demyelinating disorders. In this context, MOG-IgG-associated optic neuritis (ON) has been suggested as a new subset of optic neuropathy. However, clinical manifestations and distinctive characteristics have only rarely been described. Patients and Methods A retrospective case series of three patients with MOG-IgG-associated ON. Clinical morphological features using imaging techniques are presented. Results Three patients (8-year-old boy, 28-year-old female, 48-year-old male) were included. An 8-year-old boy suffered from a bilateral ON with severe visual loss. The best-corrected visual acuity (BCVA) was 0.05 in the right eye and finger counting in the left eye. The patient had a previous episode of acute disseminated encephalomyelitis (ADEM) with a right abducens nerve palsy. Visual acuity recovered after repeated cycles of intravenous methylprednisolone pulse therapy and 10 cycles of plasma exchange. During the last follow-up, BCVA was 0.9 in the right eye and 0.8 in the left eye. A 28-year-old female presented with a bilateral ON. Her BCVA was 0.5 in the right eye and 0.8 in the left eye. She fully recovered with pulse methylprednisolone therapy (1000 mg/d) with tapering after the second cycle and had a BCVA of 1.0 during the last follow-up visit. A 48-year-old male suffered from a relapsing bilateral ON. At first presentation, BCVA was 0.1 in the right eye and finger counting in the left eye. BCVA fully recovered after each pulse therapy with intravenous methylprednisolone (two cycles). Since the first relapse, the patient has been receiving long-term immunosuppression with rituximab. Despite rituximab and low-dose oral prednisone, the patient had another relapse with a left ON. After a third cycle with intravenous methylprednisolone, he partially recovered. BCVA at last follow-up was 1.0 in the right and 0.8 in the left eye. Conclusions MOG-IgG antibodies have been identified in different acquired demyelinating syndromes. The patients reported had an ADEM followed by bilateral ON, an isolated bilateral ON, and a relapsing bilateral ON. Individual treatment strategies led to substantial visual recovery in all patients. We recommend inclusion of MOG-IgG antibodies in the diagnostic workup at least after the first recurrence of ON since they can serve as a diagnostic and potential prognostic tool and might lead to specific therapeutic recommendations.

scholarly journals Leber’s hereditary optic neuropathy following unilateral painful optic neuritis: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chaeyeon Lee ◽  
Kyung-Ah Park ◽  
Ga-In Lee ◽  
Sei Yeul Oh ◽  
Ju-Hong Min ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Optic Neuritis ◽  
Optic Neuropathy ◽  
Visual Loss ◽  
Early Stage ◽  
Leber’S Hereditary Optic Neuropathy ◽  
Leber's Hereditary Optic Neuropathy ◽  
Intravenous Methylprednisolone ◽  
The Right ◽  
Hereditary Optic Neuropathy

Abstract Background Leber’s hereditary optic neuropathy (LHON) is a maternally inherited mitochondrial disease, characterized by acute or subacute, painless, bilateral visual loss. LHON is often misdiagnosed as optic neuritis at an early stage because of the similarity of their clinical presentation. To date, there has been no reported case of actual optic neuritis and LHON in one patient. Case presentation A 40-year-old, healthy man was referred to our clinic with acute painful visual loss in the right eye for 2 weeks. In the right eye, visual acuity decreased to 20/40, and the Ishihara colour test score was 8/14 with a relative afferent pupillary defect. Optic disc swelling was found only in the right eye, and magnetic resonance imaging revealed enhancement of the the right optic nerve, consistent with optic neuritis. After receiving 1 g of intravenous methylprednisolone daily for three days, his ocular pain resolved, and visual acuity improved to 20/20 within 2 weeks. Seven months later, the patient developed acute painless visual loss in the right eye. Visual acuity decreased to 20/200 in the right eye. There was no response to the intravenous methylprednisolone therapy at that time. Eight months later, he developed subacute painless visual loss in the left eye. Genetic testing for LHON was performed and revealed the pathologic mtDNA 11778 point mutation. Conclusions We report a case with painful unilateral optic neuritis preceding the onset of LHON. Even if a typical optic neuritis patient has completely recovered from steroid treatment once in the past, it is advisable to keep in mind the possibility of LHON if acute or subacute loss of vision subsequently or simultaneously occurs in both eyes and does not respond to steroids.

Corticosteroids in the Treatment of Acute Optic Neuritis

2020 ◽  
pp. 285-290
Author(s):  
Alan D. Penman ◽  
Kimberly W. Crowder ◽  
William M. Watkins
Keyword(s):  
Clinical Trial ◽  
Optic Neuritis ◽  
Visual Loss ◽  
Oral Prednisone ◽  
Visual Outcome ◽  
Controlled Clinical Trial ◽  
Treatment Trial ◽  
Intravenous Methylprednisolone ◽  
Acute Optic Neuritis ◽  
Optic Neuritis Treatment Trial

The Optic Neuritis Treatment Trial (ONTT) was a randomized, placebo-controlled, clinical trial in patients with a history consistent with acute unilateral optic neuritis to determine whether treatment with either oral prednisone or intravenous methylprednisolone speeded the recovery of vision and improve visual outcome. The study found that intravenous methylprednisolone (started within eight days of symptom onset) followed by oral prednisone speeded the recovery of visual loss due to optic neuritis and resulted in slightly better vision at six months. Oral prednisone alone, however, was an ineffective treatment and may increase the risk of new episodes of optic neuritis.

scholarly journals A comparative evaluation between megadose intravenous dexamethasone and intravenous methyl prednisolone in the treatment outcome of optic neuritis

2017 ◽  
Vol 5 (4) ◽  
pp. 49-54
Author(s):  
P Panjiyar ◽  
A K Sharma ◽  
G B Shrestha ◽  
A Shah
Keyword(s):  
Visual Acuity ◽  
Optic Neuritis ◽  
Visual Fields ◽  
Oral Prednisolone ◽  
Intravenous Methylprednisolone ◽  
Methyl Prednisolone ◽  
Group I ◽  
Retrobulbar Optic Neuritis ◽  
The Mean ◽  
Group Ii

To compare the efficacy of intravenous methylprednisolone and intravenous dexamethasone for the treatment of optic neuritis in terms of visual recovery and side-effects and to evaluate the clinical profile of optic neuritis patients admitted in BPKLCOS. 60 patients of acute idiopathic typical optic neuritis presenting to our centre were included in this prospective, randomized comparative study. Study population was randomly divided into two groups. Group I received intravenous dexamethasone 200 mg once daily for three days and Group II received intravenous methylprednisolone 500 mg/twelve-hourly for three days followed by oral prednisolone for 11 days. Optic neuritis was found to be common in the age group of 21 to 30 years with female preponderance. The most frequent mode of presentation was abrupt loss of vision. Retrobulbar optic neuritis dominated the study group. Both groups were age and sex-matched. The mean presenting visual acuity in group I was 0.065±0.59. The mean presenting visual acuity in group II was 0.1±0.15. On day 90 of steroid therapy, visual acuity improved to 0.98±0.073 in Group I and 0.88±0.16 in Group II (p=0.23). At three months, there was statistically significant improvement in both groups in terms of colour vision, contrast sensitivity and Goldmann visual fields as well but difference between the two groups was statistically insignificant. Intravenous dexamethasone is an effective treatment for optic neuritis, which is comparable to intravenous methylprednisolone. However, larger studies are required to establish it as a safe, inexpensive and effective modality for the treatment of optic neuritis.

scholarly journals Myelin Oligodendrocyte Glycoprotein (MOG) Antibody Disease in a 11-year-old child with COVID 19 infection

2020 ◽  
Author(s):  
Archana Khan ◽  
Hiren Panwala ◽  
Divya Ramadoss ◽  
Raju Khubchandani
Keyword(s):  
Optic Neuritis ◽  
Case Reports ◽  
Oral Prednisolone ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Intravenous Methylprednisolone ◽  
Common Presentation

Abstract Optic Neuritis is the most common presentation of MOG Antibody Disease (MOG-AD). We share our experience with a 11-year-old boy who developed MOG associated Optic Neuritis temporally associated with SARS- CoV-2 infection. He responded well to intravenous methylprednisolone therapy followed by oral prednisolone. While various neurological and ophthalmological manifestations of COVID-19 have been described previously, there are few case reports of Optic neuritis associated with COVID-19. Our case further supports the evidence to suggest that SARS CoV-2 is another such virus that triggers MOG-AD.

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