Two-year follow-up of the prospective outcomes study of pediatric optic neuritis

2021 ◽  
Vol 25 (4) ◽  
pp. e8
Author(s):  
Stacy L. Pineles ◽  
Grant T. Liu ◽  
Rui Wu ◽  
Raymond T. Kraker ◽  
Michael X. Repka ◽  
...  
Keyword(s):  
Optic Neuritis ◽  
Outcomes Study

scholarly journals Biologic Therapy in Refractory Non-Multiple Sclerosis Optic Neuritis Isolated or Associated to Immune-Mediated Inflammatory Diseases. A Multicenter Study

2020 ◽  
Vol 9 (8) ◽  
pp. 2608
Author(s):  
Alba Herrero-Morant ◽  
Carmen Álvarez-Reguera ◽  
José L. Martín-Varillas ◽  
Vanesa Calvo-Río ◽  
Alfonso Casado ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Multicenter Study ◽  
Lupus Erythematosus ◽  
Biologic Therapy ◽  
Relapsing Polychondritis ◽  
Immunosuppressive Drug ◽  
Biologic Agent ◽  
Open Label

We aimed to assess the efficacy of biologic therapy in refractory non-Multiple Sclerosis (MS) Optic Neuritis (ON), a condition more infrequent, chronic and severe than MS ON. This was an open-label multicenter study of patients with non-MS ON refractory to systemic corticosteroids and at least one conventional immunosuppressive drug. The main outcomes were Best Corrected Visual Acuity (BCVA) and both Macular Thickness (MT) and Retinal Nerve Fiber Layer (RNFL) using Optical Coherence Tomography (OCT). These outcome variables were assessed at baseline, 1 week, and 1, 3, 6 and 12 months after biologic therapy initiation. Remission was defined as the absence of ON symptoms and signs that lasted longer than 24 h, with or without an associated new lesion on magnetic resonance imaging with gadolinium contrast agents for at least 3 months. We studied 19 patients (11 women/8 men; mean age, 34.8 ± 13.9 years). The underlying diseases were Bechet’s disease (n = 5), neuromyelitis optica (n = 3), systemic lupus erythematosus (n = 2), sarcoidosis (n = 1), relapsing polychondritis (n = 1) and anti-neutrophil cytoplasmic antibody -associated vasculitis (n = 1). It was idiopathic in 6 patients. The first biologic agent used in each patient was: adalimumab (n = 6), rituximab (n = 6), infliximab (n = 5) and tocilizumab (n = 2). A second immunosuppressive drug was simultaneously used in 11 patients: methotrexate (n = 11), azathioprine (n = 2), mycophenolate mofetil (n = 1) and hydroxychloroquine (n = 1). Improvement of the main outcomes was observed after 1 year of therapy when compared with baseline data: mean ± SD BCVA (0.8 ± 0.3 LogMAR vs. 0.6 ± 0.3 LogMAR; p = 0.03), mean ± SD RNFL (190.5 ± 175.4 μm vs. 183.4 ± 139.5 μm; p = 0.02), mean ± SD MT (270.7 ± 23.2 μm vs. 369.6 ± 137.4 μm; p = 0.03). Besides, the median (IQR) prednisone-dose was also reduced from 40 (10–61.5) mg/day at baseline to. 2.5 (0–5) mg/day after one year of follow-up; p = 0.001. After a mean ± SD follow-up of 35 months, 15 patients (78.9%) achieved ocular remission, and 2 (10.5%) experienced severe adverse events. Biologic therapy is effective in patients with refractory non-MS ON.

Optic neuritis: a 5-year follow-up study of Chinese patients based on aquaporin-4 antibody status and ages

2016 ◽  
Vol 263 (7) ◽  
pp. 1382-1389 ◽  
Author(s):  
Huanfen Zhou ◽  
Shuo Zhao ◽  
Dongfang Yin ◽  
Xiaofei Chen ◽  
Quangang Xu ◽  
...  
Keyword(s):  
Optic Neuritis ◽  
Aquaporin 4 ◽  
Chinese Patients ◽  
Follow Up Study ◽  
Aquaporin 4 Antibody

scholarly journals Pediatric Optic Neuritis: Description of Four Cases and Review of the Literature

Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 855
Author(s):  
Anna Presicci ◽  
Maria Serra ◽  
Mariaclara Achille ◽  
Elvita Caputo ◽  
Lucia Margari
Keyword(s):  
Optic Neuritis ◽  
Recent Literature ◽  
Systemic Disease ◽  
Treatment Options ◽  
Igg Antibodies ◽  
Careful Evaluation ◽  
Demyelinating Disorders ◽  
Infective Etiology

Pediatric optic neuritis (PON) may be a clinically isolated and self-limiting event or may present in the context of underlying neurologic, infective, or systemic disease. PON has a high impact on the quality of life as it may or may not evolve into other acquired demyelinating syndromes (ADSs), such as multiple sclerosis (MS), neuromyelitis optica (NMO), or other syndromes related to the myelin oligodendrocyte glycoprotein IgG antibodies (MOG-IgG). These different PON phenotypes present variable clinical and radiological features, plasma and liquor biomarkers, and prognosis. We describe four pediatric cases presenting clinically with ON, with different etiopathogenetic pictures: one case had a probable infective etiology, while the others were associated with different demyelinating disorders (MS, NMO, syndrome related to MOG-IgG). We discuss the possible evolution of presenting ON in other ADSs, based on recent literature. A careful evaluation of the clinical and investigation findings and the natural course of PON is necessary to define its pathogenic pathway and evolution. Further prolonged follow-up studies are needed to highlight the predictors of PON evolution, its potential sequelae, and the best treatment options.

scholarly journals Clinical Features and Visual outcome in Acute and Recurrent Case of Optic Neuritis.

2018 ◽  
Vol 1 (01) ◽  
pp. 56-63
Author(s):  
Jyoti Bastola Paudel ◽  
Ananda Kumar Sharma ◽  
Sanjeeta Sitaula ◽  
Madhu Thapa
Keyword(s):  
Multiple Sclerosis ◽  
Natural History ◽  
Optic Neuritis ◽  
Clinical Features ◽  
Visual Evoked Potential ◽  
Evoked Potential ◽  
Oral Steroid ◽  
Visual Recovery ◽  
Visual Evoked

Introduction: Optic neuritis is an inflammation of the optic nerve that usually affects young females. In Western countries, natural history and treatment of optic neuritis(ON) has been studied extensively. However aetiology, natural history, clinical features of ON and their relation to multiple sclerosis in Asian population needs to be defined yet. Methods: 30 patients who were diagnosed as optic neuritis were included between June 2013 to December 2014 at BP Koirala Lions Centre for Ophthalmic Studies (BPKLCOS). A detailed history was obtained followed by examination of anterior and posterior segment. Assessment of visual acuity, color vision, contrast sensitivity, visual evoked potential (VEP),visual field and MRI of orbit and brain was done in all cases. All patients were treated with intravenous Methylprednisolone 500mg twice daily for 3 days followed by oral steroid for 11 days which was tapered in the next 4 days.The patients were reassessed at 2 weeks, 1 month and 3months. Results: Commonest presenting symptom was diminution of vision(65%). MRI showed multiple paraventricular oval plaques definite of multiple sclerosis in one patient and one was diagnosed as probable MS who had a single periventricular plaque. Visual evoked potential (VEP) showed increase in the mean P100 latency at 60’ and reduction in amplitude in eyes affected with optic neuritis compared to normal eyes. At 3 months follow up, 70% had good visual recovery (>6/18). The cause of non-improvement in vision was disc pallor. Optic disc pallor was detected in 37.5% of the eyes during follow up. Conclusions: Good visual recovery was observed in most eyes with acute optic neuritis. Multiple sclerosis was seen in 1 patient who had recurrent optic neuritis.

In Reply to Vitiello et al.: Acute Optic Neuritis Diagnosed by Bedside Ultrasound in an Emergency Department: Follow-Up and Clarification

2020 ◽  
Vol 59 (3) ◽  
pp. 449-451
Author(s):  
Mark Philip Saigh ◽  
Harold Martin Plauché ◽  
Christine Butts ◽  
Amer Karam Karam ◽  
Salvador J. Suau ◽  
...  
Keyword(s):  
Emergency Department ◽  
Optic Neuritis ◽  
Bedside Ultrasound ◽  
Acute Optic Neuritis

scholarly journals Acute disseminated encephalomyelitis followed by recurrent or monophasic optic neuritis in pediatric patients

2012 ◽  
Vol 19 (7) ◽  
pp. 941-946 ◽  
Author(s):  
Peter Huppke ◽  
Kevin Rostasy ◽  
Michael Karenfort ◽  
Brenda Huppke ◽  
Rainer Seidl ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Optic Neuritis ◽  
Pediatric Patients ◽  
Case Series ◽  
Acute Disseminated Encephalomyelitis ◽  
Oligoclonal Bands ◽  
Central Nervous System Disorders ◽  
Established Disease

Background: Some pediatric patients with inflammatory demyelinating central nervous system disorders cannot be classified under any of the established disease entities, making their treatment and prognosis difficult. Objective: The objective of this study is to characterize a subgroup of pediatric patients with recurrent demyelinating central nervous system disorders. Methods: This study includes a case series of pediatric patients with monophasic or recurrent acute disseminated encephalomyelitis (ADEM) who later presented with either monophasic or recurrent optic neuritis (ON). Results: We describe seven patients with a median follow-up of six years (five females, two males) who presented at a median age of 6 years (range 4–8 years) with monophasic ( n = 4) or recurrent ADEM (two to four attacks) followed by monophasic ( n = 3) or recurrent ON (two to nine attacks). Cranial magnetic resonance imaging (MRI) was typical for ADEM ( n = 6) with complete or almost complete resolution of lesions on follow-up. Cerebrospinal (CSF) studies at the time of ADEM showed a pleocytosis in six patients and were negative for oligoclonal bands (OCBs) in all. In all patients high titers for serum anti-MOG antibodies were detected. Conclusion: ADEM followed by ON is a rare but distinct clinical phenotype among pediatric patients. Further studies are needed to allow recommendations on treatment or prognosis.

Multifocal visual evoked potential evaluation for diagnosis of acute optic neuritis and for prediction of visual outcome and ganglion cell layer thinning following optic neuritis

2020 ◽  
pp. 135245852097573
Author(s):  
Gorm Pihl-Jensen ◽  
Benedikte Wanscher ◽  
Jette Lautrup Frederiksen
Keyword(s):  
Optic Neuritis ◽  
Ganglion Cell ◽  
Visual Function ◽  
Visual Evoked Potential ◽  
Evoked Potential ◽  
Conduction Block ◽  
Visual Outcome ◽  
Multifocal Visual Evoked Potential ◽  
Visual Evoked

Background:: While damage to the optic nerve following optic neuritis (ON) is readily quantifiable, the evaluation of prognosis for visual function and neuroaxonal loss in the acute ON is challenging. Objective:: The objective of this study is to investigate the value of multifocal visual evoked potential (mfVEP) in acute ON, diagnostically for acute ON and prognostically for visual outcome and subsequent ganglion cell/inner plexiform layer thickness (GCLIPLt). Methods:: A prospective cohort study of mfVEP and full-field visual evoked potential (ffVEP) in acute, unilateral ON (onset < 31 days) was conducted. Comparisons with healthy controls ( n = 30) and association analysis with follow-up optical coherence tomography (OCT) measurements (of the GCLIPLt) and visual function (Sloan low-contrast visual acuity (LCVA)) were conducted. Results:: Seventy-nine ON patients were included (mean: 17 days from onset). Excluding measurements with conduction block, ffVEP ( n = 54) and mfVEP ( n = 44) showed sensitivities of 89% and 84% to a specificity of 97%. 65/79 patients were re-examined (mean: 200 days follow-up). mfVEP amplitude and latency inter-eye asymmetry in acute ON correlated with GCLIPLt ( r = 0.587 and Spearman’s ρ = 0.597, for both, p < 0.001). mfVEP amplitude correlated with LCVA inter-eye asymmetry at follow-up ( r = 0.421, p < 0.001), mfVEP latency did not. Conclusion: mfVEP may support the prognostic evaluation of acute ON patients and prove valuable in future neuroprotective and remyelinating trials. In acute ON, the increase in diagnostic value of mfVEP to ffVEP may be limited due to widespread conduction block.

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