scholarly journals Optic Neuritis in the Older Chinese Population: A 5-Year Follow-Up Study

2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
Junqing Wang ◽  
Huanfen Zhou ◽  
Limin Qin ◽  
Chunxia Peng ◽  
Jie Zhao ◽  
...  
Keyword(s):  
Optic Neuritis ◽  
Vision Loss ◽  
Clinical Manifestations ◽  
The Elderly ◽  
Chinese Patients ◽  
First Episode ◽  
Fiber Layer ◽  
Severe Visual Loss ◽  
Older Chinese

Objective. This study aims to describe the clinical manifestations and outcomes in a cohort of older Chinese patients.Method. A retrospective study of patients aged ≥ 45 years who had a first episode of optic neuritis (ON) between May 2008 and November 2012. Clinical features at onset and last follow-up were analyzed within subgroups (age 45–65 years and age ≥ 65 years).Results. 76 patients (99 eyes) were included, of which 58% were females. The mean age at presentation was 55.53 ± 8.29 years (range: 45–83 years). Vision loss was severe at presentation, with initial best corrected vision activity (BCVA) < 20/200 in 93% and final BCVA < 20/200 in 53% of patients at 5-year follow-up. Final BCVA significantly correlated with the initial BCVA and peripapillary retinal nerve fiber layer. At last follow-up, 14.5% were diagnosed with neuromyelitis optica spectrum disorder (NMOSD), 1.3% were diagnosed with multiple sclerosis (MS), 5.2% with chronic relapsing inflammatory optic neuropathy, 1.3% with infectious ON, and 19.7% with autoimmune ON. None of the elderly group (≥65 years) developed NMOSD or MS.Conclusion. Chinese patients in the age group ≥ 65 years with ON are less likely to develop NMOSD or MS. Notwithstanding, they had more severe visual loss at onset and poor recovery.

scholarly journals Myocardial amyloidosis following multiple myeloma in a 38-year-old female patient: A case report

Open Medicine ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. 396-402
Author(s):  
Qisi Zhang ◽  
Yingli Qiao ◽  
Dongmei Yan ◽  
Yuhui Deng ◽  
Mengyang Zhang ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Plasma Cells ◽  
Laboratory Data ◽  
Young Patients ◽  
Clinical Manifestations ◽  
The Elderly ◽  
First Episode ◽  
Rapid Progression ◽  
Congo Red Staining ◽  
Impaired Cardiac Function

AbstractMultiple myeloma (MM) is an immunoglobulin-producing tumor of plasma cells, which occurs commonly in the elderly. The incidence of myocardial amyloidosis with MM is extremely low and early clinical manifestations are nonspecific. The diversity of clinical manifestations and first episode symptoms often cause misdiagnosis in young patients with myocardial amyloidosis following MM. In this study, we analyzed the clinical data of a young woman with MM and impaired cardiac function combined with echocardiography, electrocardiography (ECG), laboratory data, cell Congo Red staining, and other manifestations to diagnose amyloidosis. Considering the rapid progression, short survival, and poor prognosis in most patients, a clear, definitive, and timely diagnosis is essential for the treatment of patients with MM complicated with myocardial amyloidosis.

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 Single Intravitreal Aflibercept Injection for Unilateral Acute Nonarteritic Ischemic Optic Neuropathy

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Ziya Ayhan ◽  
Gamze Kocaoğlu ◽  
Aylin Yaman ◽  
Meltem Söylev Bajin ◽  
A. Osman Saatci
Keyword(s):  
Optic Neuropathy ◽  
Elderly Population ◽  
Visual Fields ◽  
The Elderly ◽  
Ischemic Optic Neuropathy ◽  
Fiber Layer ◽  
Nerve Fiber Layer Thickness ◽  
Intravitreal Aflibercept ◽  
Established Treatment

Acute nonarteritic ischemic optic neuropathy (ANAION) is the most common optic neuropathy in the elderly population without a well-established treatment. A 67-year-old man with a sudden painless visual loss in his left eye of one-day duration was diagnosed to have left ANAION. Next day, 2 mg aflibercept injection was injected intravitreally in OS. Visual acuity improved to 7/10 from 1/10 a week after the injection. Mean retinal nerve fiber layer thickness (RNFLT) was reduced to 159,7 μm from 182,4 μm at the first week. Visual fields improved dramatically during the follow-up of three months. The aim of this study is to present a case having ANAION treated with a single intravitreal aflibercept injection and discuss the place of intravitreal anti-VEGF injections in the treatment of armamentarium of ANAION.

Optic neuritis in the elderly: Prognosis for visual recovery and long-term follow-up

Neurology ◽  
1988 ◽  
Vol 38 (12) ◽  
pp. 1834-1834 ◽  
Author(s):  
D. M. Jacobson ◽  
H. S. Thompson ◽  
J. J. Corbett
Keyword(s):  
Optic Neuritis ◽  
The Elderly ◽  
Visual Recovery ◽  
Long Term Follow Up

scholarly journals Clinical characteristics of optic neuritis phenotypes in a 3-year follow-up Chinese cohort

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chaoyi Feng ◽  
Qian Chen ◽  
Guixian Zhao ◽  
Zhenxin Li ◽  
Weimin Chen ◽  
...  
Keyword(s):  
Optic Neuritis ◽  
Clinical Characteristics ◽  
Plexiform Layer ◽  
Inner Plexiform Layer ◽  
Fiber Layer ◽  
Corrected Visual Acuity ◽  
Chinese Cohort ◽  
Relapse Rates ◽  
New Onset

AbstractTo evaluate the clinical characteristics of optic neuritis (ON) with different phenotypes. This prospective study recruited patients with new-onset ON between January 2015 and March 2017 who were followed-up for 3 years. They were divided into the myelin oligodendrocyte glycoprotein-seropositive (MOG-ON), aquaporin-4-seropositive (AQP4-ON), and double-seronegative (seronegative-ON) groups, and their clinical characteristics and imaging findings were evaluated and compared. Two-hundred-eighty patients (405 eyes) were included (MOG-ON: n = 57, 20.4%; AQP4-ON: n = 98, 35.0%; seronegative-ON: n = 125, 44.6%). The proportion of eyes with best-corrected visual acuity > 20/25 at the 3-year follow-up was similar between the MOG-ON and seronegative-ON groups; the proportion in both groups was higher than that in the AQP4-ON group (p < 0.001). Relapse rates were higher in the MOG-ON and AQP4-ON groups than in the seronegative-ON group (p < 0.001). Average retinal nerve fiber layer (RNFL) thickness at 3 years was similar between the MOG-ON and AQP4-ON groups (63.41 ± 13.39 and 59.40 ± 11.46 μm, p = 0.476) but both were thinner than the seronegative-ON group (74.06 ± 11.14 μm, p < 0.001). Macular ganglion cell-inner plexiform layer (GCIPL) revealed the same pattern. Despite RNFL and GCIPL thinning, the MOG-ON group’s outcome was as favorable as that of the seronegative-ON group, whereas the AQP4-ON group showed unsatisfactory results.

scholarly journals Epidemiology, clinical presentation, treatment, and follow‐up of chronic mercury poisoning in China: a retrospective analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sun Yawei ◽  
Long Jianhai ◽  
Zhao Junxiu ◽  
Peng Xiaobo ◽  
Qiu Zewu
Keyword(s):  
Peripheral Neuropathy ◽  
Occupational Exposure ◽  
Large Population ◽  
Clinical Manifestations ◽  
Patient Characteristics ◽  
Mercury Content ◽  
Chinese Patients ◽  
Neurological Injury ◽  
Mercury Poisoning

Abstract Background There are no reports on the incidence of chronic mercury poisoning in a large population in China. This study investigated the epidemiology, clinical manifestations, treatment, and follow-up of Chinese patients with chronic mercury poisoning. Methods Data for 288 mercury poisoning patients were collected at our hospital from July 2014 to September 2019, including sex, age, admission time, blood mercury content, urine mercury content, creatinine, urinary mercury/creatinine ratio, 24-h urinary protein levels, electromyography (EMG) findings, renal biopsy, and follow-up. Patient characteristics were evaluated by statistical and correlation analyses. Results First, mercury poisoning in China mainly occurred through occupational exposure and the inappropriate use of mercury-containing cosmetics and Chinese folk remedies (CFRs). Second, the most common symptoms were nervous system (50.3 %), kidney (16.4 %) and breathing (8.0 %). Mercury poisoning-induced Nephrotic syndrome (NS) and peripheral neuropathy are common long-term complications. The complications of occupational and cosmetics-induced mercury poisoning are consistent with international belief. However, the NS caused by CFRs is mainly membranous nephropathy and the probability of peripheral neuropathy caused by CFRs is higher than other pathogens. Third, follow-up data shows that 13 patients with EMG-confirmed neurological injury, 10 showed full recovery after 38.50 ± 8.03 months. Furthermore, among 18 patients with NS, 15 had normal urine protein and serum albumin levels after 22.67 ± 10.26 months. Conclusions Regulation of skin-lightening cosmetic products, safety surveillance of CFRs, and prevention and control of occupational exposure must be improved to decrease the incidence of mercury poisoning in China.

scholarly journals Retinal Nerve Fiber Layer Thickness in Multiple Sclerosis With and Without Optic Neuritis: a Four-year Follow-up Study

2021 ◽  
Author(s):  
Abdullah S. Al-Mujaini ◽  
Maiysa S. Al-Mujaini ◽  
Buthaina I. Sabt
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Nerve Fiber ◽  
Retinal Nerve Fiber Layer ◽  
Control Group ◽  
Healthy Controls ◽  
Fiber Layer ◽  
Nerve Fiber Layer ◽  
Rnfl Thickness

Abstract Background: Multiple sclerosis (MS) is an autoimmune disease that attacks the central nervous system, with optic neuritis (ON) being a common early manifestation. Retinal nerve fiber layer (RNFL) thickness may be a biomarker of neuroaxonal damage in MS patients. We sought to evaluate changes in RNFL thickness over four years in Omani MS patients with or without ON in comparison to a healthy control group. Methods: This retrospective case-control study involved 27 MS patients and 25 healthy controls. Optical coherence tomography was performed upon first diagnosis and at a four-year follow-up. Differences in mean RNFL thickness were calculated. Results: A total of 51 eyes from the MS group and 50 eyes from the control group were evaluated. There was a significant reduction in mean RNFL thickness among MS patients with ON at follow-up (81.21 versus 72.14 µm; P = .003), whereas no significant RNFL thinning was observed among MS patients without ON. However, there was a significant reduction in RNFL thickness among MS patients compared to healthy controls (76.79 versus 93.72 µm; P = .009), regardless of ON presence/absence. Conclusions: Axonal damage was seen in the optic nerves of Omani MS patients. Moreover, there was a significant reduction in RNFL thickness among MS patients with ON as the disease progressed; however, while there was evidence of RNFL thinning in MS patients without ON, this difference lacked statistical significance. Evaluation of RNFL thickness may represent a useful biomarker for monitoring disease progression in MS and its association with ON.

scholarly journals Gender effect on neuromyelitis optica spectrum disorder with aquaporin4-immunoglobulin G

2016 ◽  
Vol 23 (8) ◽  
pp. 1104-1111 ◽  
Author(s):  
Sung-Min Kim ◽  
Patrick Waters ◽  
Mark Woodhall ◽  
Yoo-Jin Kim ◽  
Jin-Ah Kim ◽  
...  
Keyword(s):  
Optic Neuritis ◽  
Neuromyelitis Optica ◽  
Immunoglobulin G ◽  
Age At Onset ◽  
Disease Onset ◽  
Clinical Manifestations ◽  
Spectrum Disorder ◽  
Pattern Reversal ◽  
Neuromyelitis Optica Spectrum Disorder

Background: Neuromyelitis optica spectrum disorder with aquaporin4-immunoglobulin G (NMOSD-AQP4) is an inflammatory disease characterised by a high female predominance. However, the effect of gender in patients with NMOSD-AQP4 has not been fully evaluated. Objective: The aim of this study was to determine the effect of gender in clinical manifestations and prognosis of patients with NMOSD-AQP4. Methods: The demographics, clinical and radiological characteristics, pattern reversal visual evoked potential (VEP) test results, and prognosis of 102 patients (18 males) with NMOSD-AQP4 were assessed. Results: Male patients had a higher age at onset (48.7 vs 41 years, p = 0.037) and less optic neuritis as the onset attack (17% vs 44%, p = 0.026), higher tendency to manifest as isolated myelitis over the follow-up period (67% vs 28%, p = 0.005), fewer optic neuritis attacks per year (0.08 vs 0.27, p < 0.001), and shorter relative P100 latency on VEP testing (97.1% vs 108.3%, p = 0.001). Moreover, male gender was significantly associated with the absence of optic neuritis attacks over the follow-up period independent of their age of onset. Conclusion: In NMOSD-AQP4 patients, gender impacts on disease onset age and site of attack. This may be an important clue in identifying NMOSD-AQP4 patients with limited manifestations as well as in predicting their clinical courses.

scholarly journals Conservative Management of Complicated Colonic Diverticulitis in Early and Late Elderly

Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 29
Author(s):  
Gennaro Perrone ◽  
Mario Giuffrida ◽  
Elena Bonati ◽  
Gabriele Luciano Petracca ◽  
Antonio Tarasconi ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Elderly Patients ◽  
Conservative Management ◽  
Acute Diverticulitis ◽  
The Elderly ◽  
Complicated Diverticulitis ◽  
First Episode ◽  
Colonic Diverticulitis ◽  
Acute Colonic Diverticulitis

Background and Objectives: The management of complicated diverticulitis in the elderly can be a challenge and initial non-operative treatment remains controversial. In this study, we investigate the effectiveness of conservative treatment in elderly people after the first episode of complicated diverticulitis. Materials and Methods: This retrospective single-centre study describes 71 cases of elderly patients with complicated acute colonic diverticulitis treated with conservative management at Parma University Hospital from 1 January 2012 to 31 December 2019. Diverticulitis severity was staged according to WSES CT driven classification for acute diverticulitis. Patients was divided into two groups: early (65–74 yo) and late elderly (>75 yo). Results: We enrolled 71 elderly patients conservatively treated for complicated acute colonic diverticulitis, 25 males and 46 females. The mean age was 74.78 ± 6.8 years (range 65–92). Localized abdominal pain and fever were the most common symptoms reported in 34 cases (47.88%). Average white cells count was 10.04 ± 5.05 × 109/L in the early elderly group and 11.24 ± 7.89 in the late elderly group. CRP was elevated in 29 (78.3%) cases in early elderly and in 23 late elderly patients (67.6%). A CT scan of the abdomen was performed in every case (100%). Almost all patients were treated with bowel rest and antibiotics (95.7%). Average length of stay was 7.74 ± 7.1 days (range 1–48). Thirty-day hospital readmission and mortality were not reported. Average follow-up was 52.32 ± 31.8 months. During follow-up, home therapy was prescribed in 48 cases (67.6%). New episodes of acute diverticulitis were reported in 20 patients (28.1%), elevated WBC and chronic NSAID therapy were related to a higher risk of recurrence in early elderly patients (p < 0.05). Stage IIb-III with elevated WBC during first episode, had a higher recurrence rate compared to the other CT-stage (p = 0.006). Conclusions: The management of ACD in the elderly can be a challenge. Conservative treatment is safe and effective in older patients, avoiding unnecessary surgery that can lead to unexpected complications due to co-morbidities.

scholarly journals The effect of optic neuritis treatment trial (ONTT) combined corticosteroid regimen on pattern reversal visual evoked potentials: a prospective follow-up study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Padmini Dahanayake ◽  
Tharaka L. Dassanayake ◽  
Manoji Pathirage ◽  
Saman Senanayake ◽  
Mike Sedgwick ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Optic Neuritis ◽  
First Episode ◽  
Pattern Reversal ◽  
Treatment Trial ◽  
Normal Range ◽  
P100 Latency ◽  
Pre Treatment ◽  
Optic Neuritis Treatment Trial

Abstract Background The combined corticosteroid regimen of the original Optic Neuritis Treatment Trial (ONTT) is used in many centers to treat optic neuritis. Though pattern reversal visual evoked potentials (PRVEPs) are a sensitive, standard measure of visual conduction in optic neuritis, no studies hitherto have investigated the effect of combined ONTT regimen on PRVEPs. We aimed to determine the effect of combined corticosteroid regimen of the ONTT on changes of PRVEPs in patients with first-episode optic neuritis over 3 months post-treatment. Methods This is a prospective, observational study in which 44 patients with optic neuritis were seen pre-treatment (baseline) and follow-up, at 1 month (FU1) and 3 months (FU2). Twenty-nine patients were treated with ONTT combined regimen (ONTT+ Group) while 15 were conservatively managed without corticosteroids (ONTT- Group). The median latency and amplitude values of the P100 PRVEP component and the visual acuity (i.e. LogMAR values) at pre-treatment, FU1 and FU2 were compared in the two groups using Friedman’s rank test and Wilcoxon Signed Ranks test. Results Median P100 latency improved significantly (to the normal range) as early as by 1 month after the commencement of treatment in the ONTT+ Group, and then remained significantly lower than the baseline over next 2 months. In the ONTT- Group, the median P100 latency improved more slowly over the two follow up assessments and reached the normal range by 3 months. Median visual acuity values also improved significantly at 1 and 3 months after the commencement of treatment in the ONTT+ Group but not in the ONTT- Group. Conclusion ONTT combined corticosteroid regimen improves conduction in the visual pathways of patients with first-episode optic neuritis earlier than does conservative management. We provide electrodiagnostic evidence that combined ONTT regimen–compared with conservative management–results in early remission of visual conduction abnormalities in first-episode optic neuritis.

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