Tan X, Wang L, Zhang Y X, Liu K Q, Zhou L, Chen D, Zhou M L, Qiu W, Yang H
Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou 510060, China.
People's Hospital of NanCheng County, Fuzhou 344700, China.
Zhonghua Yi Xue Za Zhi. 2020 Feb 25;100(7):498-503. doi: 10.3760/cma.j.issn.0376-2491.2020.07.004.
To compare the effects of different treatment and prevention regimens on recovery and relapse rate in patients with myelin oligodendrocyte glycoprotein antibody-related optic neuritis (MOG-ON). Retrospective study of the records of 37 patients with MOG-ON in ZhongShan Ophthalmology Center from January 2014 to December 2018. Patients with first-ever MOG-ON (first-ever group) were subdivided into intravenous methylprednisolone pulse group (Pulse group) and high dose methylprednisolone without pulse regimen group (non-pulse group). Comparisons were taken on visual acuity (VA), visual field (VF), visual evoked potential amplitude (VEP) and retinal nerve fiber layer thickness (RNFLT). Effect of different prevention regimens, either low dose prednisone or low dose of prednisone (2.5-10 mg/Day) combined with mycophenolate mofetil (MMF) (0.5-1 g/Day) , as well as the annual relapse rate (ARR) were compared. Among 25 patients of first-ever MOG-ON group (19 patients in pulse group and 6 patients in non-pulse group), VF of pulse group showed significant recovery, with MD value of (-7±8) dB at 1 m after onset and (-26±11) dB at onset (<0.01), while non-pulse group showed significant VF recovery only at 6 m after onset, with MD value of (-9±9) dB at 6 m and (-22±11) dB at onset (<0.01). However, no significant difference of VA, VF, VEP and RNFL could be found between the two groups on at all follow-up time points (>0.05). Among 12 patients with at least one relapse (relapse group), 9 patients (75%) were given low-dose of prednisone plus MMF for relapse prevention. The ARR was 0.77 (0.21-4.5) before and 0 (0-0.41) after the regimen, respectively (<0.05). Intravenous methylprednisolone pulse therapy in acute phase of MOG-ON may accelerate the recovery of visual function and improve the prognosis. Low-dose of prednisone combined with MMF may reduce the recurrence rate of MOG-ON.
比较不同治疗和预防方案对髓鞘少突胶质细胞糖蛋白抗体相关视神经炎（MOG-ON）患者恢复情况和复发率的影响。对中山大学中山眼科中心2014年1月至2018年12月期间37例MOG-ON患者的病历进行回顾性研究。首次发生MOG-ON的患者（首次发病组）被分为静脉注射甲泼尼龙冲击组（冲击组）和未采用冲击方案的高剂量甲泼尼龙组（非冲击组）。比较两组患者的视力（VA）、视野（VF）、视觉诱发电位振幅（VEP）和视网膜神经纤维层厚度（RNFLT）。比较不同预防方案（低剂量泼尼松或低剂量泼尼松（2.5-10mg/天）联合霉酚酸酯（MMF）（0.5-1g/天））的效果以及年复发率（ARR）。在25例首次发病的MOG-ON组患者中（冲击组19例，非冲击组6例），冲击组的视野在发病后1个月时显示出显著恢复，平均缺损（MD）值从发病时的（-22±11）dB改善至1个月时的（-7±8）dB（<0.01），而非冲击组仅在发病后6个月时视野有显著恢复，MD值从发病时的（-22±11）dB改善至6个月时的（-9±9）dB（<0.01）。然而，在所有随访时间点，两组患者的VA、VF、VEP和RNFL均无显著差异（>0.05）。在12例至少有一次复发的患者（复发组）中，9例（75%）采用低剂量泼尼松加MMF进行复发预防。预防方案实施前和实施后的ARR分别为0.77（0.21-4.5）和0（0-0.41）（<0.05）。MOG-ON急性期静脉注射甲泼尼龙冲击治疗可能加速视功能恢复并改善预后。低剂量泼尼松联合MMF可能降低MOG-ON的复发率。
