- Time to steroid treatment in severe acute optic neuritis. [Journal Article]
- BBBrain Behav 2018 Jun 22; :e01032
- CONCLUSIONS: The beneficial effects of early onset steroid treatment of ON is limited to a few months whereas the long-term prognosis is independent of the timing of treatment.
- Ocular manifestations of emerging arboviruses: Dengue fever, Chikungunya, Zika virus, West Nile virus, and yellow fever. [Review]
- JFJ Fr Ophtalmol 2018 Jun 18
- Arboviruses are viral diseases transmitted by mosquitoes and tick bites. They are a major cause of morbidity and sometimes mortality. Their expansion is constant and due in part to climate change and...
Arboviruses are viral diseases transmitted by mosquitoes and tick bites. They are a major cause of morbidity and sometimes mortality. Their expansion is constant and due in part to climate change and globalization. Mostly found in tropical regions, arboviruses are sometimes the source of epidemics in Europe. Recently, the Chikungunya virus and the Zika virus were responsible for very large epidemics impacting populations that had never been in contact with those viruses. There are currently no effective antiviral treatments or vaccines. Ocular manifestations due to those infections are thus more frequent and increasingly better described. They are sometimes, as with Zika, complicated by a congenital ocular syndrome. The goal of this review is to describe the ophthalmological manifestations of Dengue fever, Chikungunya virus, Zika virus, West Nile virus, and yellow fever.
- [Clinical and immunological characteristics and predicted factors of vision outcome in patients with acute severe bilateral optic neuritis]. [Journal Article]
- ZYZhonghua Yi Xue Za Zhi 2018 Jun 05; 98(21):1674-1678
- Objective: To analyze the clinical and immunological characteristics of acute severe bilateral optic neuritis, and to explore the predictive factors of vision outcome and relapse so as to save visua...
Objective: To analyze the clinical and immunological characteristics of acute severe bilateral optic neuritis, and to explore the predictive factors of vision outcome and relapse so as to save visual function and avoid or alleviate vision disability. Methods: Forty-eight inpatients confirmed with acute severe bilateral optic neuritis from January 2013 to June 2015 were included and followed up. The clinical features, immunological findings, optic nerve imaging, visual function outcome and predictors of relapse were statistically analyzed. Results: Acute severe bilateral optic neuritis accounted for 7.3% of the total number of optic neuritis in the same period. There were 35 cases (72.9%) with monophasic course, and 13 cases (27.1%) with recurrence or other central nervous system involvement during the follow-up period; 11 (22.9%) in 48 patients with positive AQP4-IgG; AQP4-IgG-positive patients had a higher recurrence rate (P<0.001) and poorer visual function prognosis (P=0.034) than antibody-negative patients; the baseline visual acuity (P=0.004), early treatment response (P=0.012) and number of involved optic nerve segments (P=0.016) were associated with end point visual function. Positive AQP4-IgG(OR 13.486, 95% CI 1.971-16.263)and combining with other autoimmune antibodies (OR 5.591, 95% CI 1.502-15.621)were independently associated with relapse. Conclusions: Acute severe bilateral optic neuritis is not unusual and may cause blindness or visual disability. The positive rate of AQP4-IgG and the recurrence rate of the disease are low in our study. The necessity for long-term immunotherapy requires individual consideration. The baseline visual acuity, involved segment number of optic nerve and response to early treatment are associated with prognosis of visual function. Patients with AQP4-IgG positive and other autoimmune antibodies are easy to relapse. Whether the antibody-negative bilateral optic neuritis is a heterogeneous disease and the relationship with classic NMO or NMOSD deserve further research.
- [The role of aquaporin 4 antibody in the injury of retinal microstructure in neuromyelitis optica spectrum disorders]. [Journal Article]
- ZNZhonghua Nei Ke Za Zhi 2018 Jun 01; 57(6):435-439
- Objective: To evaluate the injury of retinal microstructure using optical coherence tomography (OCT) and investigate the role of aquaporin 4 antibody (AQP4 Ab) in this injury process. Methods: Fort...
Objective: To evaluate the injury of retinal microstructure using optical coherence tomography (OCT) and investigate the role of aquaporin 4 antibody (AQP4 Ab) in this injury process. Methods: Forty patients with neuromyelitis optica spectrum disorders (NMOSD) were retrospectively studied, each of whom reported at least one episode of optic neuritis (ON), namely 59 ON eyes involved in all. All patients were divided into two subgroups based on AQP4 Ab tests including 25 patients (37 ON eyes) with AQP4 positive (Ab(+)/NMOSD group) and 15 patients (22 ON eyes) negative (Ab(-)/NMOSD group). In addition, 10 healthy controls (20 eyes) matched for age and sex (HC group) were analyzed. Spectral domain optical coherence tomography (SD-OCT) was used to quantify peripapillary retinal nerve fiber layer (RNFL). Nonparametric test was used to compare differences between groups. Results: Age distribution and gender ratio were comparable in three groups (P>0.05). Visual acuity in ON eyes of Ab(+)/NMOSD group was worse than that of Ab(-)/NMOSD group (P=0.02). There were no significant differences between Ab(+)/NMOSD and Ab(-)/NMOSD in aspects of disease duration (2.6 vs. 1.9 year), ON episodes (2 vs. 1), longitudinal extensive transverse myelitis (LETM) ratio (48.0% vs. 66.7%), NMOSD specific intracranial lesions ratio (32.0% vs. 53.3%), positive autoimmune antibody ratio (52.0% vs. 20.0%) (P= 0.13, 0.08, 0.25, 0.18, 0.06, respectively). The thickness of temporal, superior, nasal, inferior and average RNFL in ON eyes of both Ab(+)/NMOSD and Ab(-)/NMOSD group were thinner than those in eyes of HC group (all P<0.05). The thickness of superior and inferior RNFL in ON eyes of Ab(+)/NMOSD were 61.0 μm and 62.0 μm, which was thinner than those of Ab(-)/NMOSD 94.5 μm and 97.0 μm (P=0.03 and 0.01, respectively). Conclusions: RNFL reflects the injury of retinal microstructure in NMOSD patients. AQP4 Ab seropositivity is correlated to the severity of RNFL damage, implying the potential role of AQP4 Ab in this pathological process.
- Why Therapeutic Compliance in Optic Neuritis Deserves to Be More Than Just a Footnote: Response. [Journal Article]
- JNJ Neuroophthalmol 2018 Jun 19
- Using the Anterior Visual System to Assess Neuroprotection and Remyelination in Multiple Sclerosis Trials. [Review]
- CNCurr Neurol Neurosci Rep 2018 Jun 19; 18(8):49
- Clinical trials using agents directed at neuroprotection and remyelination in multiple sclerosis (MS) are needed. As optic neuritis (ON) is common in people with MS and the pathology of ON is similar...
Clinical trials using agents directed at neuroprotection and remyelination in multiple sclerosis (MS) are needed. As optic neuritis (ON) is common in people with MS and the pathology of ON is similar to other MS lesions in the brain, measurements of the anterior visual system are frequently utilized in neuroprotection and remyelination trials. Understanding the strengths and weaknesses of the measurements is vital when interpreting the results of this research.
- Retinal ganglion cell loss in neuromyelitis optica: a longitudinal study. [Journal Article]
- JNJ Neurol Neurosurg Psychiatry 2018 Jun 19
- CONCLUSIONS: This study clearly shows GCIP loss independent of ON attacks in aquaporin4-antibody-seropositive NMOSD. Potential explanations for progressive GCIP thinning include primary retinopathy, drug-induced neurodegeneration and retrograde neuroaxonal degeneration from lesions or optic neuropathy. pRNFL thickening in the patients presenting with attacks during F/U might be indicative of pRNFL susceptibility to inflammation.
- Structural and visual functional deficits in a rat model of neuromyelitis optica spectrum disorders related optic neuritis. [Journal Article]
- EEExp Eye Res 2018 Jun 15
- Neuromyelitis optica spectrum disorders (NMOSD) are a group of autoimmune astrocytopathies in the central nervous system, which are mainly caused by immunoglobulin G (IgG) against astrocyte water cha...
Neuromyelitis optica spectrum disorders (NMOSD) are a group of autoimmune astrocytopathies in the central nervous system, which are mainly caused by immunoglobulin G (IgG) against astrocyte water channel aquaporin-4 (AQP4). In this study, we aimed to establish a model of NMOSD-related optic neuritis (NMOSD-ON) and to evaluate the progressive changes of the optic nerve and visual function. AQP4 IgG-positive serum from NMOSD patients was injected into the subarachnoid space of the rat optic nerve to induce the NMOSD-ON model (AQP4 + group), and healthy serum was injected as the control. The visual evoked potential, pupillary light reflex and optical coherence tomography were monitored every week for 3 weeks after induction. Compared with the control group, the amplitude of the N1-P1 peak and pupillary light reflex in the AQP4+ group were reduced within the first week and then remained low thereafter. Consistent with the functional deficits, the thickness of the peripapillary retinal nerve fiber layer in the AQP4 + group was also greatly reduced. At the end of 3 weeks, there was a loss of retinal ganglion cells and the optic nerves showed characteristic NMOSD-like pathologic changes, including deposition of AQP4 IgG, local astrocyte damage, demyelination, microglia activation, macrophage infiltration and axonal injury. Thus, we have established an NMOSD-ON rat model with deficits in the optic nerve and visual function that may be a valuable tool for exploring the mechanism of NMOSD-ON and evaluating its potential therapeutic treatment.
- Pain in optic neuropathies. [Journal Article]
- NSNeurol Sci 2018; 39(Suppl 1):25-31
- Pain occurs with optic neuropathies associated with inflammatory central nervous system diseases (MS and NMO), idiopathic intracranial hypertension and spontaneous hypotension, giant cell arteritis, ...
Pain occurs with optic neuropathies associated with inflammatory central nervous system diseases (MS and NMO), idiopathic intracranial hypertension and spontaneous hypotension, giant cell arteritis, immunomediated systemic diseases, compressive lesions, or infective disorders. Pain can precede the onset of visual loss in acute optic neuritis, it can be irradiated to the orbital region in giant cell arteritis and parasellar compressive optic neuropathies, or it may be located to the back of the eye with posterior scleritis. History of symptoms together with complete neuro-ophthalmological examination must guide the differential diagnosis and neuroimaging. Painful visual loss due to different pathophysiological mechanisms requires specific treatment and prognosis.
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- Why Therapeutic Compliance in Optic Neuritis Deserves to be More Than Just a Footnote. [Journal Article]
- JNJ Neuroophthalmol 2018 Jun 12