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J Neurol. 2016 Jul;263(7):1382-9. doi: 10.1007/s00415-016-8155-7. Epub 2016 May 9.

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

Author information

1
Department of Ophthalmology, The Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Haidian district, Beijing, China.
2
Department of Ophthalmology, The First Affiliated Hospital of Chinese People's Liberation Army General Hospital, Beijing, China.
3
Department of Ophthalmology, The Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Haidian district, Beijing, China. docwsh301@126.com.

Abstract

Little work has been performed on the long-term outcome of optic neuritis (ON) according to the status of aquaporin-4 antibody (AQP4-Ab) and long-term prognosis in older patients in China. This study retrospectively analyzed medical records in a cohort of Chinese patients with 5-year follow-up according to AQP4-Ab status and ages from January 2009 to December 2010. The clinical features, laboratory findings and risk factors for prognosis were analyzed. A total of 128 ON patients were included, 66.4 % of whom were female. The median age at onset was 36.8 years (range 18-73). Serum AQP4-Ab was positive in 45 (35.2 %) patients, with greater frequency in the female, bilateral, and recurrent ON groups (48.2, 42.5 and 53.6 %, respectively). Seropositive AQP4-Ab ON patients had worse visual recovery compared to seronegative patients (p = 0.033). The average and four quadrants of retinal nerve fiber layer (RNFL) thickness were significantly thinner in the seropositive group than in the seronegative group (p < 0.05). At 5-year follow-up, the ON recurrence rate was higher in the seropositive AQP4-Ab patients (37/45, 82.3 %) than in the seronegative patients (35/83, 42.2 %, p < 0.001). Among the seropositive patients, 40 % (18/45) developed neuromyelitis optica (NMO). Only 1.2 % (1/83) of the seronegative patients developed NMO and 4.8 % (4/83) developed to MS. Further, the multivariate analysis in seropositive AQP4-Ab patients showed that two risk factors for transverse myelitis (TM) episode were ocular pain and recurrence within 1 year. The older patients had worse visual outcome after the first episode of ON than the younger patients (p = 0.007). However, the two groups did not differ significantly with regard to prevalence of AQP4-Ab, long-term visual recovery and the risk of developing to NMO/MS.

KEYWORDS:

Aquaporin-4 antibody; Multiple sclerosis; Neuromyelitis optica; Optic neuritis

PMID:
27159992
DOI:
10.1007/s00415-016-8155-7
[Indexed for MEDLINE]

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