中国水通道蛋白4及髓鞘少突胶质细胞糖蛋白抗体血清阳性男性视神经炎的不同特征
Different Characteristics of Aquaporin-4 and Myelin Oligodendrocyte Glycoprotein Antibody-Seropositive Male Optic Neuritis in China.
作者信息
Song Honglu, Zhou Huanfen, Yang Mo, Wang Junqing, Liu Hongjuan, Sun Mingming, Xu Quangang, Wei Shihui
机构信息
Department of Ophthalmology, Chinese PLA General Hospital, Beijing, China.
Department of Ophthalmology, Bethune International Peace Hospital, Shijiazhuang, Hebei, China.
出版信息
J Ophthalmol. 2019 Apr 1;2019:4015075. doi: 10.1155/2019/4015075. eCollection 2019.
PURPOSE
To describe different clinical characteristics and prognosis of optic neuritis (ON) in male patients with seropositive aquaporin-4 antibody (AQP4-Ab) or myelin oligodendrocyte glycoprotein antibody (MOG-Ab) in China.
METHOD
Males with ON were recruited from the Neuro-ophthalmology Department of the Chinese People's Liberation Army, General Hospital from January 2016 to February 2018. They were assigned to two groups based on antibodies status: MOG-Ab-seropositive ON (MOG-ON) and aquaporin-4 Ab-seropositive ON (AQP4-ON).
RESULTS
Seventy-six male patients were assessed, including 44 MOG-ON (57.9%) and 32 AQP4-ON (42.1%). The MOG-ON patients were significantly younger at onset compared to the AQP4-ON group ( < 0.001). Frequencies of optic disc swelling, presence of abnormal autoimmune antibodies, and elevated levels of CSF IgG were significantly higher in the AQP4-ON group than the MOG-ON group (=0.040, =0.016, and =0.10, respectively). At the final visit, 85.3% of MOG-ON eyes had increased visual acuity (≥0.5) compared to 35.1% of AQP4-ON eyes ( < 0.001). The ratio of this steroid-dependent condition is higher in MOG-ON patients than the AQP4-ON group ( < 0.001). The ratio of conversion to NMO is higher in the AQP4-ON group than the MOG-ON group, with more AQP4-ON patients developing NMO by the follow-up (=0.012). MOG-ON patients had thicker average peripapillary retinal nerve fiber layers and macular ganglion cell-inner plexiform than AQP4-ON patients (=0.008 and =0.012, respectively). Orbital MRI revealed more AQP4-ON patients had chiasmal involvement than MOG-ON patients ( < 0.001).
CONCLUSION
Male MOG-ON patients had different clinical features including earlier age of onset, higher optic disc swelling ratio, better visual acuity recovery, thicker peripapillary retinal nerve fiber and macular ganglion cell-inner plexiform layers, and less chiasmal involvement than male AQP4-ON patients. Serum antibody may be a potential biomarker for determining visual prognosis in male ON.
目的
描述中国血清学阳性水通道蛋白4抗体（AQP4-Ab）或髓鞘少突胶质细胞糖蛋白抗体（MOG-Ab）男性视神经炎（ON）患者的不同临床特征及预后。
方法
选取2016年1月至2018年2月在中国人民解放军总医院神经眼科就诊的男性ON患者。根据抗体状态将他们分为两组：MOG-Ab血清学阳性ON（MOG-ON）组和水通道蛋白4抗体血清学阳性ON（AQP4-ON）组。
结果
共评估76例男性患者，其中MOG-ON组44例（57.9%），AQP4-ON组32例（42.1%）。MOG-ON组患者发病时年龄显著低于AQP4-ON组（<0.001）。AQP4-ON组视盘肿胀、异常自身免疫抗体存在及脑脊液IgG水平升高的频率显著高于MOG-ON组（分别为=0.040、=0.016和=0.10）。末次随访时，MOG-ON组85.3%的患眼视力提高（≥0.5），而AQP4-ON组为35.1%（<0.001）。MOG-ON组患者激素依赖情况的比例高于AQP4-ON组（<0.001）。AQP4-ON组转化为视神经脊髓炎（NMO）的比例高于MOG-ON组，随访中有更多AQP4-ON患者发展为NMO（=0.012）。MOG-ON组患者视乳头周围视网膜神经纤维层和黄斑神经节细胞-内丛状层的平均厚度大于AQP4-ON组（分别为=0.008和=0.012）。眼眶MRI显示，AQP4-ON组累及视交叉的患者多于MOG-ON组（<0.001）。
结论
男性MOG-ON患者具有不同的临床特征，包括发病年龄较早、视盘肿胀比例较高、视力恢复较好、视乳头周围视网膜神经纤维层和黄斑神经节细胞-内丛状层较厚以及视交叉受累较少。血清抗体可能是男性ON患者视觉预后的潜在生物标志物。
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