Department of Ophthalmology, Military General Hospital of Beijing PLA, Beijing, China.
Department of Ophthalmology, Military General Hospital of Beijing PLA, Beijing, China
Br J Ophthalmol. 2019 Oct;103(10):1423-1428. doi: 10.1136/bjophthalmol-2018-313142. Epub 2018 Dec 4.
BACKGROUND/AIMS: To evaluate the status of myelin oligodendrocyte glycoprotein antibodies (MOG-IgG) in chronic relapsing inflammatory optic neuropathy (CRION) and investigate its different clinical characteristics and prognosis.
Patients diagnosed with CRION were recruited by the Neuro-ophthalmology Department of the Chinese People's Liberation Army General Hospital from December 2015 to April 2017. Based on antibody status, they were assigned to either the MOG-CRION or seronegative-CRION groups.
A total of 33 patients (38 eyes) were assessed and divided into the following groups: 22 (66.7%) MOG-CRION and 11 (33.3%) seronegative-CRION. The ratio of female to male was 1:1, and 81.8% of total CRION patients were adults (≥18 years). A total of 29 eyes (76.3%) showed severe visual loss (<20/200) during the first optic neuritis episode, and 37 eyes (72.5%) demonstrated good visual recovery (>20/40) during the final follow-up. The mean onset age of MOG-CRION patients was 28 ± 16 years (range 6-62), which was significantly younger than that of seronegative-CRION (45 ± 12 years, range 22-59) (p=0.029). The intraorbital and canalicular segments were highly involved in the orbital MRI of CRION patients. During the final follow-up, MOG-CRION patients had more bilateral involvement (p=0.008) and higher annualised relapse rates compared with the seronegative-CRION patients (p=0.019).
CRION was predominantly found in adults with unilateral ON and exhibited a higher rate of seropositive MOG-IgG. MOG-CRION, which may be a disparate subtype of MOG-IgG-induced demyelinating disease that needs further investigation, was found in younger patients at onset, with more bilateral involvement and more relapse tendency.
背景/目的：评估髓鞘少突胶质细胞糖蛋白抗体（MOG-IgG）在慢性复发性炎症性视神经病变（CRION）中的状态，并探讨其不同的临床特征和预后。
解放军总医院神经眼科于 2015 年 12 月至 2017 年 4 月招募了被诊断为 CRION 的患者。根据抗体状态，他们被分为 MOG-CRION 或血清阴性-CRION 组。
共评估了 33 名患者（38 只眼），分为以下两组：22 名（66.7%）MOG-CRION 和 11 名（33.3%）血清阴性-CRION。男女比例为 1:1，81.8%的 CRION 患者为成年人（≥18 岁）。初次视神经炎发作时，共有 29 只眼（76.3%）出现严重视力下降（<20/200），37 只眼（72.5%）在最终随访时视力恢复良好（>20/40）。MOG-CRION 患者的平均发病年龄为 28±16 岁（范围 6-62），明显低于血清阴性-CRION（45±12 岁，范围 22-59）（p=0.029）。CRION 患者的眶内和管内段在眼眶 MRI 中高度受累。在最终随访时，MOG-CRION 患者较血清阴性-CRION 患者更易发生双侧受累（p=0.008），年复发率更高（p=0.019）。
CRION 主要发生在单侧 ON 的成年人中，血清阳性 MOG-IgG 发生率较高。MOG-CRION 可能是一种不同的 MOG-IgG 诱导脱髓鞘疾病亚型，需要进一步研究，其发病年龄较小，双侧受累更多，复发倾向更高。
