髓鞘少突胶质细胞糖蛋白抗体阳性相关儿童视神经炎的临床特征：一项队列研究。
Clinical Characteristics of Pediatric Optic Neuritis With Myelin Oligodendrocyte Glycoprotein Seropositive: A Cohort Study.
机构信息
Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China.
Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
出版信息
Pediatr Neurol. 2018 Jun;83:42-49. doi: 10.1016/j.pediatrneurol.2018.03.003. Epub 2018 Mar 13.
BACKGROUND
The clinical characteristics of patients with pediatric optic neuritis with seropositive myelin oligodendrocyte glycoprotein antibodies in Asia have not been reported.
METHODS
Patients ≤18 years-old with acute-onset optic neuritis were enrolled. Serum myelin oligodendrocyte glycoprotein and aquaporin-4 antibodies were detected and patients were followed for at least six months. The clinical features were evaluated among myelin oligodendrocyte glycoprotein-seropositive optic neuritis, aquaporin-4-seropositive optic neuritis, and double seronegative optic neuritis. Best-corrected visual acuity, thickness of optic disc retinal nerve fiber layer, and macular ganglion cell complex were measured by optical coherence tomography.
RESULTS
Among myelin oligodendrocyte glycoprotein-optic neuritis, aquaporin-4-optic neuritis, and seronegative-optic neuritis, the percentages of best-corrected visual acuity measured better than 0.8 (20/25) at the six-month visit were 89.47%, 33.33%, and 82.26%, respectively, a rate that is significantly better in patients with myelin oligodendrocyte glycoprotein-optic neuritis and seronegative-optic neuritis (P = 0.02). The average peripapillary retinal nerve fiber layers were 58.03 ± 8.73 µm, 64.34 ± 12.88 µm, and 78.12 ± 13.34 µm for the patients with myelin oligodendrocyte glycoprotein-optic neuritis, aquaporin-4-optic neuritis, and seronegative-optic neuritis, respectively, which showed no statistical difference between patients with myelin oligodendrocyte glycoprotein-optic neuritis and aquaporin-4-optic neuritis (P = 0.089), but were both thinner than patients with seronegative-optic neuritis (P = 0.001).
CONCLUSIONS
The recovery of visual acuity in patients with myelin oligodendrocyte glycoprotein-optic neuritis was as good as in patients with seronegative-optic neuritis, and the retinal nerve fiber layer of the optic nerve head showed thinning as severe as that of the patients with aquaporin-4-optic neuritis.
背景
亚洲儿童视神经炎伴血清阳性髓鞘少突胶质细胞糖蛋白抗体患者的临床特征尚未报道。
方法
纳入急性起病的视神经炎患者，≤18 岁。检测血清髓鞘少突胶质细胞糖蛋白和水通道蛋白-4 抗体，并对患者进行至少 6 个月的随访。评估髓鞘少突胶质细胞糖蛋白阳性视神经炎、水通道蛋白-4 阳性视神经炎和双阴性视神经炎患者的临床特征。通过光学相干断层扫描测量最佳矫正视力、视盘视网膜神经纤维层厚度和黄斑神经节细胞复合体。
结果
在髓鞘少突胶质细胞糖蛋白性视神经炎、水通道蛋白-4 性视神经炎和阴性性视神经炎中，在 6 个月时视力优于 0.8（20/25）的患者比例分别为 89.47%、33.33%和 82.26%，髓鞘少突胶质细胞糖蛋白性视神经炎和阴性性视神经炎患者的视力改善明显更好（P=0.02）。视神经盘视网膜神经纤维层的平均厚度分别为 58.03±8.73µm、64.34±12.88µm 和 78.12±13.34µm，在髓鞘少突胶质细胞糖蛋白性视神经炎、水通道蛋白-4 性视神经炎和阴性性视神经炎患者中，髓鞘少突胶质细胞糖蛋白性视神经炎和水通道蛋白-4 性视神经炎患者之间无统计学差异（P=0.089），但均较阴性性视神经炎患者薄（P=0.001）。
结论
髓鞘少突胶质细胞糖蛋白性视神经炎患者的视力恢复与阴性性视神经炎患者一样好，视神经头的神经纤维层显示出与水通道蛋白-4 性视神经炎患者一样严重的变薄。
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