Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil Songpa-Gu, Seoul, 138-736, Republic of Korea.
Neurol Sci. 2014 May;35(5):781-3. doi: 10.1007/s10072-014-1635-6. Epub 2014 Feb 1.
To identify factors distinguishing subsequent neuromyelitis optica (NMO) from multiple sclerosis (MS) after first-ever optic neuritis (ON), we compared ophthalmic findings and MRI features of 24 NMO and 55 MS patients who initially presented with ON. The female-to-male ratio was higher, and bilateral ON was more common in NMO patients than in MS patients (p = 0.044 and p = 0.020, respectively). The visual acuity (VA) score was higher in NMO patients (p = 0.034), and a greater proportion of NMO patients had a VA score ≥ 5 (p = 0.003). The frequency of patients without pattern-reversal and flash visual evoked potentials was higher in the NMO group (p = 0.015). Brain MRI abnormalities were more common in the MS group (p = 0.001). The optic chiasm was affected in 25 % of NMO patients and was unaffected in MS patients, although it did not reach statistical significance (p = 0.096). There were no differences with respect to the severity of swelling and enhancement of the optic nerve. In conclusion, severe optic nerve damage at the first ON attack was associated with subsequent development of NMO, whereas presence of brain MRI abnormalities was associated with developing MS.
为了明确首次视神经炎（ON）后区分继发视神经脊髓炎（NMO）和多发性硬化（MS）的因素，我们比较了 24 例 NMO 和 55 例 MS 患者的眼部表现和 MRI 特征，这些患者均为首发 ON。NMO 患者中女性与男性的比例更高，且双侧 ON 更为常见（p = 0.044 和 p = 0.020）。NMO 患者的视力（VA）评分更高（p = 0.034），VA 评分≥5 的患者比例更高（p = 0.003）。NMO 患者中无图形反转和闪光视觉诱发电位的患者比例更高（p = 0.015）。MS 组的脑 MRI 异常更为常见（p = 0.001）。NMO 患者中 25%的视交叉受累，而 MS 患者不受累，尽管这没有达到统计学意义（p = 0.096）。视神经肿胀和强化的严重程度没有差异。总之，首次 ON 发作时严重的视神经损伤与随后发生的 NMO 相关，而脑 MRI 异常与 MS 的发生相关。
