Department of Ophthalmology, Chinese PLA General Hospital, Fuxing Road No.28, Haidian district, Beijing 100853, China; Department of Ophthalmology, Bethune International Peace Hospital, Shijiazhuang, Hebei, China.
Department of Ophthalmology, Chinese PLA General Hospital, Fuxing Road No.28, Haidian district, Beijing 100853, China.
J Neurol Sci. 2019 May 15;400:83-89. doi: 10.1016/j.jns.2019.03.014. Epub 2019 Mar 16.
To investigate the clinical characteristics and outcomes of myelin oligodendrocyte glycoprotein antibody-seropositive optic neuritis (MOG-ON) in patients with varying ages of onset in China.
Patients displaying symptoms of MOG-ON were recruited from the Neuro-ophthalmology Department in the Chinese People's Liberation Army General Hospital from January 2016 to May 2018. They were assigned to one of three subgroups based on age of onset: pediatric (<18 years), young (18-46 years), and middle-aged (>46 years) MOG-ON.
110 patients (188 eyes) were assessed, including 58 pediatric (52.7%), 34 young (30.9%), and 18 middle-aged (16.4%) patients. Of the pediatric patients, 93.9% had good recovery of visual acuity (≥0.5) compared with 79.7% of young patients and 66.7% of middle-aged patients (p < .001). The annual relapse rate was lower in the pediatric group than young and middle-aged groups (0.32 ± 0.50 vs 0.73 ± 0.87 vs 0.49 ± 1.08, p = .036). Six children (10.3%) were diagnosed with acute disseminated encephalomyelitis, while seven young patients (20.6%) were diagnosed with aquaporin-4 antibody seronegative neuromyelitis optica spectrum disorder upon follow-up. The average peripapillary RNFL and macular GCIPL thicknesses were not statistically different between subgroups (p = .996, p = .608). Overall, MRIs of the optic nerve showed perineural enhancement in 52.0% of patients and longitudinal extensive involvement in 87.7%. MRIs also revealed a greater proportion of pediatric patients with intracranial optic nerve involvement than in the other two subgroups (45.4% vs. 21.2% vs. 36.7%, p = .014).
Pediatric ON was the most common MOG-ON subgroup. Pediatric patients had different clinical features, including better recovery of visual acuity, lower annual relapse rate, and more intracranial optic nerve involvement than young and middle-aged patients. Additionally, age of onset may be a potential predictor for determining visual prognosis with MOG-ON.
研究中国不同发病年龄的髓鞘少突胶质细胞糖蛋白抗体阳性视神经炎（MOG-ON）患者的临床特征和结局。
本研究纳入了 2016 年 1 月至 2018 年 5 月期间在中国人民解放军总医院神经眼科就诊的 MOG-ON 患者，根据发病年龄将患者分为三组：儿童组（<18 岁）、青年组（18-46 岁）和中年组（>46 岁）。
本研究共纳入 110 例（188 只眼）患者，其中儿童组 58 例（52.7%），青年组 34 例（30.9%），中年组 18 例（16.4%）。儿童组患者视力恢复良好（≥0.5）的比例明显高于青年组（93.9%比 79.7%）和中年组（93.9%比 66.7%）（p<0.001）。儿童组的年复发率低于青年组和中年组（0.32±0.50 比 0.73±0.87 比 0.49±1.08，p=0.036）。6 例（10.3%）患儿被诊断为急性播散性脑脊髓炎，7 例（20.6%）青年患者在随访中被诊断为水通道蛋白 4 抗体阴性视神经脊髓炎谱系疾病。各组间视盘周围神经纤维层（RNFL）和黄斑神经节细胞内丛状层（GCIPL）厚度无统计学差异（p=0.996，p=0.608）。视神经 MRI 显示，52.0%的患者存在神经周围强化，87.7%的患者存在纵向广泛受累。MRI 还显示，儿童组患者颅内视神经受累的比例高于其他两组（45.4%比 21.2%比 36.7%，p=0.014）。
儿童型 ON 是最常见的 MOG-ON 亚型。与青年和中年患者相比，儿童患者具有不同的临床特征，包括更好的视力恢复、更低的年复发率和更多的颅内视神经受累。此外，发病年龄可能是预测 MOG-ON 患者视力预后的一个潜在指标。
