P303 Serial MRI, VEP, SEP and biotesiometry in acute optic neuritis: Value of baseline results to predict the development of new lesions at one year follow up

Abstract Background The diagnosis of immunoglobulin G serum antibodies to myelin oligodendrocyte glycoprotein (MOG-IgG) associated inflammatory demyelinating disorders can be confirmed by the presence of MOG-IgG, yet its general cut-off concentration had not yet to be defined. Whether it is significant that a seropositive lower titer level for MOG-IgG could cause disease is still unknown. Case presentation A 55-year-old Chinese woman presented with acute optic neuritis manifestations in the left eye. MRI showed a left optic nerve demyelination image and a T2 hyperintensity at C7 vertebral segment without any extra specific lesions. AQP4-IgG was tested seronegative, while the MOG-IgG was positive, titer 1:10, by indirect immunofluorescence. Considering the lower concentration, we retested serum MOG-IgG after 6 months of steroid therapy, using cell-based assay, then we still got the same result which was also barely above the negative cut-off value. So, the clinical diagnose was “possible MOG-IgG-associated encephalomyelitis”. The woman’s condition improved by steroid therapy without relapse. Conclusions Seropositive MOG-IgG, even at a lower level, could lead to an autoimmune inflammatory demyelination. In adults, it commonly presents as ON and myelitis. Although the patient had a considerable reaction, steroid therapy could not make MOG-IgG seronegative, instead, the antibody may persist even during remission and flare-ups can recur after steroid withdrawal. Therefore, a long-term follow-up is necessary to monitor the patient’s prognosis.

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The risk of multiple sclerosis developing in patients with isolated idiopathic optic neuritis in Brazil

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x1991000400002 ◽

1991 ◽

Vol 49 (4) ◽

pp. 377-383 ◽

Cited By ~ 5

Author(s):

Marco Aurélio Lana-Peixoto ◽

Maria Inês Vilhena Lana-Peixoto

Keyword(s):

Multiple Sclerosis ◽

Spinal Cord ◽

Optic Neuritis ◽

The West ◽

Fellow Eye ◽

Spinal Cord Involvement ◽

Rate Of Progression ◽

The Mean ◽

One Year

We studied 88 patients with isolated idiopathic optic neuritis (IION) in order to evaluate the rate of progression to multiple sclerosis (MS) in Brazil. The patients were reassessed from one month to nine years after the development of the HON (mean follow-up was 4.6 years). There were 52 men and 36 women with ages ranging from three to 59 years (mean 24.3 years). Bilateral optic neuritis occurred in 19 patients whereas sequential involvement of the fellow eye after an interval longer than four weeks occurred in other 19 patients. Recurrences in the same eye occurred in seven cases. Nine patients (10.8%) developed clinically definitive MS - 13.9% of the women and 7.7% of the men with IION. The median age at the time of diagnosis of MS was 25 years. The mean interval between HON and the emergence of other MS signs varied from one month to five years - median one year. Sixty-seven percent of these, patients developed signs of spinal cord involvement. Our findings when compared to published series in different countries are closer to figures reported in Japan than those in the West.

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Immunotherapy in complex treatment of acute optic neuritis associated with herpesvirus infection

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-3-339-343 ◽

2021 ◽

pp. 339-343

Author(s):

D.А. Povalyaeva ◽

◽

V.V. Egorov ◽

G.P. Smoliakova ◽

L.P. Danilova ◽

...

Keyword(s):

Optic Neuritis ◽

Irrigation System ◽

Functional Results ◽

Complex Treatment ◽

Herpesvirus Infection ◽

Results Of Treatment ◽

Acute Optic Neuritis ◽

Key Words Optic Neuritis ◽

Retrobulbar Space

Purpose. Evaluation clinical efficacy of complex treatment of optic neuritis (ON) associated with herpesvirus infection (HVI), including methods of immunotherapy. Material and methods. The clinical study involved 26 people (26 eyes) with acute ON associated with HVI. The treatment regimen for all patients within 10 days included delivery through irrigation system implanted into the retrobulbar space to optic nerve: solutions Dexamethasone on decreasing scheme, Emoxypine 1% 0.5 ml and Dicynone 12.5% 0.5 ml. All patients were divided into 2 groups depending on characteristics of therapy. The 1st group consisted of 12 patients, who were treated according to the standard method. 2nd group consisted of 14 patients who received additional intramuscular Imunofan. The duration of immunotherapy was 10–12 days. Results. Analysis of obtained datas showed that more significant positive dynamics was noted in the clinical course of ON in patients of the 2nd group of observation in comparison with the 1st group. Conclusion. The developed strategy of etiotropic and pathogenetic immunotherapy at ON associated with HVI infection, allows shortening recovery time and improving functional results of treatment in absence of relapses of disease within 1 year of follow-up. Key words: optic neuritis, herpesvirus infection, corticosteroid therapy, immunotherapy.

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A serial MRI study following optic nerve mean area in acute optic neuritis

Brain ◽

10.1093/brain/awh284 ◽

2004 ◽

Vol 127 (11) ◽

pp. 2498-2505 ◽

Cited By ~ 82

Author(s):

S. J. Hickman

Keyword(s):

Optic Nerve ◽

Optic Neuritis ◽

Acute Optic Neuritis ◽

Mri Study ◽

Serial Mri

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Outer retinal changes following acute optic neuritis

Multiple Sclerosis Journal ◽

10.1177/1352458515590646 ◽

2015 ◽

Vol 22 (3) ◽

pp. 362-372 ◽

Cited By ~ 38

Author(s):

Omar A Al-Louzi ◽

Pavan Bhargava ◽

Scott D Newsome ◽

Laura J Balcer ◽

Elliot M Frohman ◽

...

Keyword(s):

Optic Neuritis ◽

Mixed Effects ◽

Retinal Layer ◽

Strongly Correlated ◽

Dynamic Changes ◽

Percentage Decrease ◽

Acute Optic Neuritis ◽

The Mean ◽

Function Testing

Background: Retinal nerve fiber and ganglion cell+inner plexiform (GCIP) layer thinning following multiple sclerosis-related acute optic neuritis (AON) is well described. However, whether AON results in changes in the inner nuclear (INL), outer plexiform (OPL), outer nuclear (ONL) and/or photoreceptor segment (PS) layers remains undetermined. Objectives: The objective of this paper is to determine if INL+OPL and/or ONL+PS changes occur following AON. Methods: Thirty-three AON patients underwent serial optical coherence tomography (OCT) and visual function testing (mean follow-up: 25 months). Longitudinal changes in retinal layer thickness were analyzed using mixed-effects linear regression. Results: Four months following AON, the mean decrease in GCIP thickness relative to baseline was 11.4% ( p < 0.001). At four months, a concomitant 3.4% increase in average ONL+PS thickness was observed ( p < 0.001). The percentage decrease in GCIP thickness and increase in ONL+PS thickness were strongly correlated ( r = −0.70; p < 0.001). Between months 4 to 12, ONL+PS thickness declined and, at 12 months, was no longer significantly different from baseline (mean change: 0.5%; p = 0.37). Similar, albeit less robust, changes in the INL+OPL were observed. Conclusions: Following AON, dynamic changes occur in the deep retinal layers, which are proportional to GCIP thinning. These novel findings help further our understanding of the biological and/or anatomical sequelae resulting from AON.

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