scholarly journals Analysis of the Pathogenesis of Experimental Autoimmune Optic Neuritis

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Takeshi Kezuka ◽  
Yoshihiko Usui ◽  
Hiroshi Goto
Keyword(s):  
Multiple Sclerosis ◽  
Animal Models ◽  
Optic Neuritis ◽  
Vision Loss ◽  
Strong Association ◽  
Acute Onset ◽  
Advanced Therapies ◽  
Short Period ◽  
Organ Specific ◽  
The Right

Optic neuritis associated with multiple sclerosis has a strong association with organ-specific autoimmune disease. The goal of our research is to establish an optimal organ-specific animal model to elucidate the pathogenetic mechanisms of the disease and to develop therapeutic strategies using the model. This paper is divided into five sections: (1) clinical picture of optic neuritis associated with multiple sclerosis, (2) elucidation of pathogenesis using animal models with inflammation in optic nerve and spinal cord, (3) clinical relevance of concurrent encephalomyelitis in optic neuritis model, (4) retinal damage in a concurrent multiple sclerosis and optic neuritis model, and (5) development of novel therapies using mouse optic neuritis model. Advanced therapies using biologicals have succeeded to control intractable optic neuritis in animal models. This may ultimately lead to prevention of vision loss within a short period from acute onset of optic neuritis in human. By conducting research flexibly, ready to switch from the bench to the bedside and from the bedside to the bench as the opportunity arises, this strategy may help to guide the research of optic neuritis in the right direction.

scholarly journals Association of MMP-2 (–1306 C/T) Gene Polymorphism with Predisposition to Optic Neuritis and Optic Neuritis Together with Multiple Sclerosis

Medicina ◽  
2018 ◽  
Vol 54 (2) ◽  
pp. 29 ◽  
Author(s):  
Rasa Liutkevičienė ◽  
Alvita Vilkevičiūtė ◽  
Mantas Banevičus ◽  
Raminta Miežytė ◽  
Loresa Kriaučiūnienė
Keyword(s):  
Multiple Sclerosis ◽  
Gene Polymorphism ◽  
Optic Neuritis ◽  
Vision Loss ◽  
Matrix Metalloproteinase 2 ◽  
Control Group ◽  
Autoimmune Inflammatory Disease ◽  
Pcr Method ◽  
Polymerase Chain ◽  
The Relationship

Background and objective: Optic neuritis (ON) is characterized by painful, usually monocular vision loss with decreased visual acuity and defects of the visual field and color vision. The etiology and pathophysiology of ON is not completely clear. It is thought that a matrix metalloproteinase 2 (MMP-2) gene plays an essential role in this autoimmune inflammatory disease. The aim of this study was to determine the relationship between the MMP-2 (-1306 C/T) rs243865 gene polymorphism and ON, and that of ON with multiple sclerosis. Materials and methods: Patients with ON/ON and multiple sclerosis and a control group of healthy individuals were enrolled in this study. The genotyping test of the MMP-2 (-1306 C/T) was carried out using a real-time polymerase chain reaction (PCR) method. Results: Analysis revealed that T allele at the MMP-2 (-1306 C/T) was less frequent in the ON group compared to the control group (14.5% vs. 23.3%, p = 0.031), and was associated with decreased likelihood of ON development (OR = 0.566; 95% CI: 0.333-0.962; p = 0.036). No significant associations were revealed while comparing the subgroups of ON patients with and without multiple sclerosis. Conclusion: The MMP-2 (-1306 C/T) gene polymorphism was found to be associated with ON development.

Paroxysmal kinesigenic dyskinesia–like phenotype in multiple sclerosis

2017 ◽  
Vol 23 (13) ◽  
pp. 1795-1797 ◽  
Author(s):  
Roxana Pop ◽  
Stefan Kipfer
Keyword(s):  
Multiple Sclerosis ◽  
Gene Mutations ◽  
Brain Magnetic Resonance Imaging ◽  
Acute Onset ◽  
Intravenous Steroid ◽  
Paroxysmal Kinesigenic Dyskinesia ◽  
Hyperkinetic Movement Disorder ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Rapid Regression

In April 2015, a 20-year-old woman with multiple sclerosis (MS) presented with acute onset of repetitive abnormal postures and choreatic movements of the right arm, precipitated by voluntary movements (online video 1 and 2). Brain magnetic resonance imaging (MRI) showed a new active MS lesion involving the basal ganglia on the left side (Figure 1(a)). Intravenous steroid treatment resulted in rapid regression of this paroxysmal kinesigenic dyskinesia (PKD)-like hyperkinetic movement disorder. The patient became asymptomatic within 3 months. PKD is characterized by recurrent uni- or bilateral choreoathetosis and usually represents an autosomal dominant inherited disorder caused by PRRT2 gene mutations. As in the present case, a PKD-like phenotype may be associated with MS relapses in presumably genetic negative cases.

Optic Neuritis

2019 ◽  
pp. 3-8
Author(s):  
Matthew J. Thurtell ◽  
Robert L. Tomsak
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Optic Neuropathy ◽  
Clinical Characteristics ◽  
Acute Onset ◽  
Visual Recovery ◽  
Imaging Findings ◽  
Treatment Trial ◽  
Management Options ◽  
Optic Neuritis Treatment Trial

Optic neuritis is the most frequent cause of acute-onset optic neuropathy in young adults and is often encountered in clinical practice. In this chapter, we begin by reviewing the cardinal signs of optic neuropathy. We review the clinical characteristics and workup of optic neuritis. We review factors that increase the risk for developing multiple sclerosis. We discuss atypical clinical and imaging findings that should prompt further evaluation for other causes of optic neuritis, such as neuromyelitis optica. Lastly, we discuss the management options for optic neuritis, with reference to the findings from the Optic Neuritis Treatment Trial, and the prognosis for visual recovery.

scholarly journals Purtscher-like retinopathy presented a honeycomb-like pattern in optical coherence topography angiography

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Bing Li ◽  
Donghui Li ◽  
Youxin Chen
Keyword(s):  
Blood Flow ◽  
Vision Loss ◽  
Acute Onset ◽  
Pathological Process ◽  
Optical Coherence ◽  
Cotton Wool Spots ◽  
Before And After ◽  
Retinal Oedema ◽  
Hypointense Signal ◽  
The Right

Abstract Background To report a case of Purtscher-like retinopathy (PUR) and the optical coherence tomography (OCT) and OCT angiography (OCT-A) findings before and after treatment. Case presentation A 65-year-old male presented with acute onset of vision loss for 2 weeks. Fundus examination revealed cotton-wool spots, retinal haemorrhage, and Purtscher flecken spread around the optic disc in the right eye. He was diagnosed with Purtscher-like retinopathy because he lacked any traumatic medical history. OCT presented some band-like hyperreflective lesions at the inner nuclear layer, which are indicative of paracentral acute middle maculopathy (PAMM). OCT-A revealed apparent reduction in blood flow signal at the deep retina and choriocapillaris layers with a honeycomb-like hypointense signal pattern. After 3 months of follow-up, OCT revealed resolution of retinal oedema, but PAMM lesions remained visible. Based on OCT-A, the honeycomb-like pattern turned into a homogeneous reduction in blood flow with small patches of hypointense signal areas in the choriocapillaris. Conclusion This case presented a new OCT-A sign in PUR with a honeycomb-like hypointense signal at the choriocapillaris layer, indicating the involvement and ischaemia of the choroid during the pathological process.

scholarly journals Visual Loss from Choroidal Melanoma Mimicking Neurological Syndromes

2017 ◽  
Vol 9 (1) ◽  
pp. 31-35
Author(s):  
Karim Hammamji ◽  
Ehud Reich ◽  
Amit Arora ◽  
Victoria M.L. Cohen ◽  
Mandeep S. Sagoo
Keyword(s):  
Optic Neuritis ◽  
Visual Loss ◽  
Vision Loss ◽  
White Male ◽  
Choroidal Melanoma ◽  
Proton Beam Radiotherapy ◽  
Pet Ct ◽  
Oral Steroids ◽  
History Of ◽  
The Right

Melanoma of the eye is rare, but can mimic a range of disorders. This report highlights 2 cases of choroidal melanoma with vision loss mimicking neurological diagnoses. The first patient is a 41-year-old white male with a known history of multiple sclerosis and a previous episode of optic neuritis in the right eye, who presented with a 6-month history of decreased vision in the same eye, and occasional photopsiae. He was treated with 2 courses of oral steroids for presumed recurrent optic neuritis. After a temporary improvement in his symptoms, his vision worsened, following which he had a head MRI, which revealed a solid intraocular mass. He was subsequently diagnosed with a choroidal melanoma for which he was treated successfully with ruthenium-106 plaque brachytherapy. The second patient is a 57-year-old female, who presented with a progressive cerebellar syndrome under investigation by the neurology service, as well as decreased vision in the right eye. Her visual acuity gradually deteriorated and her neurological assessment, which included a PET-CT, revealed uptake in the right eye. The diagnosis of a choroidal melanoma was made, and following conservative treatment with proton beam radiotherapy, she had an enucleation of the eye. Intraocular tumours can masquerade as many different entities. Unexplained unilateral visual loss, especially if it is atypical for a neurological syndrome, should prompt dilated fundoscopy and referral to an ophthalmologist.

scholarly journals Leber’s hereditary optic neuropathy misdiagnosed as optic neuritis and Lyme disease in a patient with multiple sclerosis

2018 ◽  
Vol 11 (1) ◽  
pp. e227109 ◽  
Author(s):  
Melinda Chang
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Optic Disc ◽  
Optic Neuropathy ◽  
Vision Loss ◽  
White Matter Lesions ◽  
Leber’S Hereditary Optic Neuropathy ◽  
Leber's Hereditary Optic Neuropathy ◽  
Intravenous Steroids ◽  
Hereditary Optic Neuropathy

A 28-year-old Caucasian man developed sudden painless vision loss in the right eye. He was diagnosed with optic neuritis. MRI showed white matter lesions consistent with multiple sclerosis (MS), but no optic nerve enhancement. Eight months later, the left eye was affected in the same manner. Examination showed right optic atrophy and apparent left optic disc swelling. Workup revealed positive Lyme IgG. Differential diagnosis included optic neuritis and Lyme optic neuropathy, and he was treated with intravenous steroids, intravenous immunoglobulin, plasmapheresis and intravenous ceftriaxone without improvement. Neuro-ophthalmology consultation led to identification of pseudo-optic disc oedema, and Leber’s hereditary optic neuropathy (LHON) was suspected and confirmed by genetic testing. LHON may occur in association with MS, and should be considered in patients with MS with vision loss atypical for optic neuritis. This is especially important as new treatments for LHON (including gene therapy) are currently undergoing clinical trials.

Optic Nerve Glioma and Optic Neuritis Mimicking One Another: Case Report

Neurosurgery ◽  
2005 ◽  
Vol 57 (1) ◽  
pp. E190-E190 ◽  
Author(s):  
Luis M. Tumialán ◽  
Sanjay S. Dhall ◽  
Valérie Biousse ◽  
Nancy J. Newman
Keyword(s):  
Magnetic Resonance Imaging ◽  
Optic Nerve ◽  
Magnetic Resonance ◽  
Optic Neuritis ◽  
Visual Loss ◽  
Radiographic Finding ◽  
Acute Onset ◽  
Resonance Imaging ◽  
Optic Nerve Glioma ◽  
The Right

Abstract OBJECTIVE AND IMPORTANCE: The clinical and radiographic presentations of optic nerve gliomas and optic neuritis are for the most part distinct and their diagnoses straightforward. We present two cases illustrating the occasional difficulty one can encounter in distinguishing neoplastic from inflammatory optic neuropathies. CLINICAL PRESENTATION: Patient 1 is a 17-year-old girl who presented with acute onset of pain and rapidly progressive visual loss in the right eye. Patient 2 is a 38-year-old man who presented with painless progressive visual loss in the left eye. INTERVENTION: Patient 1 was initially diagnosed with idiopathic retrobulbar optic neuritis. Interval increase of the optic nerve on magnetic resonance imaging prompted a biopsy of the optic nerve, which revealed a pilocytic astrocytoma. Patient 2 was found to have left optic nerve enhancement most consistent with an optic nerve glioma. Before a biopsy, the patient spontaneously improved without treatment, indicating an inflammatory process. CONCLUSION: Differentiating between optic nerve neoplasm and inflammation may be difficult. On occasion, the classic clinical finding of pain with eye movement and the radiographic finding of enlargement and enhancement of the optic nerve may be misleading. Open biopsy of the optic nerve is indicated only after a completely negative metabolic, infectious, and inflammatory workup; interval increase of the optic nerve on magnetic resonance imaging; and failure of the patient to recover vision.

scholarly journals Purtscher-like retinopathy presented a honeycomb-like pattern in optical coherence topography angiography

2019 ◽  
Author(s):  
Bing Li ◽  
Youxin Chen ◽  
Donghui Li
Keyword(s):  
Blood Flow ◽  
Vision Loss ◽  
Acute Onset ◽  
Pathological Process ◽  
Optical Coherence ◽  
Cotton Wool Spots ◽  
Before And After ◽  
Retinal Oedema ◽  
Hypointense Signal ◽  
The Right

Abstract Background: To report a case of Purtscher-like retinopathy (PUR) and the optical coherence tomography (OCT) and OCT angiography (OCT-A) findings before and after treatment. Case presentation: A 65-year-old male presented with acute onset of vision loss for 2 weeks. Fundus examination revealed cotton-wool spots, retinal haemorrhage, and Purtscher flecken spread around the optic disc in the right eye. He was diagnosed with Purtscher-like retinopathy because he lacked any traumatic medical history. OCT presented some band-like hyperreflective lesions at the inner nuclear layer, which are indicative of paracentral acute middle maculopathy (PAMM). OCT-A revealed apparent reduction in blood flow signal at the deep retina and choriocapillaris layers with a honeycomb-like hypointense signal pattern. After 3 months of follow-up, OCT revealed resolution of retinal oedema, but PAMM lesions remained visible. Based on OCT-A, the honeycomb-like pattern turned into a homogeneous reduction in blood flow with small patches of hypointense signal areas in the choriocapillaris. Conclusion: This case presented a new OCT-A sign in PUR with a honeycomb-like hypointense signal at the choriocapillaris layer, indicating the involvement and ischaemia of the choroid during the pathological process.

scholarly journals Incidence of Optic Neuritis and the Associated Risk of Multiple Sclerosis for Service Members of U.S. Armed Forces

2021 ◽  
Author(s):  
Weidong Gu ◽  
Nathan T Tagg ◽  
Nileshkumar L Panchal ◽  
Cherrishe A Brown-Bickerstaff ◽  
Julie M Nyman ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Medical Records ◽  
Vision Loss ◽  
Armed Forces ◽  
Service Members ◽  
Identification Algorithm ◽  
Case Identification ◽  
Conversion Rates ◽  
The U.S

ABSTRACT Introduction Optic neuritis (ON), an acute inflammation of the optic nerve resulting in eye pain and temporary vision loss, is one of the leading causes of vision-related hospital bed days in the U.S. Military and may be a harbinger of multiple sclerosis (MS). We developed a case identification algorithm to estimate incidence rates of ON and the conversion rate to MS based on a retrospective assessment of medical records of service members (SMs) of the U.S. Armed Force. Materials and Methods Electronic medical records (EMRs) from 2006 to 2018 in the Defense Medical Surveillance System were screened using the case identification algorithms for ON and MS diagnosis. The incidences rates of ON were calculated. The rates of conversion to MS was modeled using the Kaplan–Meier survival analysis. Results The overall incidence rate of ON was 8.1 per 100,000 from 2006 to 2018. Females had a rate (16.9 per 100,000) three times higher than males. Most (68%) of subsequent diagnoses of MS were made within 1 year after diagnosis of ON. The overall 5-year risk of progression to MS was 15% (11%–16% for 95% CI). The risk of conversion to MS in females was significantly higher than in males. Conclusions We developed an efficient tool to explore the EMR database to estimate the burden of ON in the U.S. Military and the MS conversion based on a dynamic cohort. The estimated conversion rates to MS feeds into inform retention and fitness-for-duty policy in these SMs.

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