Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA.
Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.
Am J Ophthalmol. 2020 Dec;220:110-114. doi: 10.1016/j.ajo.2020.07.014. Epub 2020 Jul 21.
To re-evaluate the population-based incidence of optic neuritis in the era of aquaporin-4-immunoglobulin G (AQP4-IgG) and myelin oligodendrocyte glycoprotein (MOG)-IgG, which are biomarkers of optic neuritis that is distinct from multiple sclerosis (MS). Over the past 15 years, 2 new biomarkers have been discovered that allow for further characterization of the cause of atypical optic neuritis: AQP4-IgG and MOG-IgG.
Retrospective, population-based cohort.
population-based.
all residents of Olmsted County, Minnesota, with optic neuritis diagnosed between January 1, 2000, and December 31, 2018.
The Rochester Epidemiology Project database was used to identify patients. Sera were tested for AQP4-IgG and MOG-IgG by using a live-cell-based flow cytometry assay. Main outcome measurements were the incidence and cause of optic neuritis.
Optic neuritis was diagnosed in 110 patients, providing an annual incidence of 3.9 per 100,000. The final diagnosis was MS in 57%, idiopathic in 29%, MOG-IgG-associated disorder in 5%, AQP4-IgG-seropositive neuromyelitis optic spectrum disorder (NMOSD) in 3%, infectious type in 2%, sarcoidosis in 2%, seronegative NMOSD in 1%, and medication-related in 1%. All 3 patients positive for AQP4-IgG had more than 1 optic neuritis attack, 2 with residual no light perception vision in at least 1 eye. Among MOG-IgG-positive patients, 4 of 6 patients had recurrent optic neuritis, and all 6 had a final visual acuity of 20/30 or better.
At a population level, AQP4-IgG and MOG-IgG account for 9% of optic neuritis and are associated with recurrent attacks, but MOG-IgG optic neuritis has a better visual outcome than AQP4-IgG optic neuritis.
重新评估水通道蛋白 4 免疫球蛋白 G（AQP4-IgG）和髓鞘少突胶质细胞糖蛋白（MOG-IgG）时代视神经炎的人群发病率，这两种标志物是与多发性硬化症（MS）不同的视神经炎的生物标志物。在过去的 15 年中，发现了 2 种新的生物标志物，可以进一步确定非典型视神经炎的病因：AQP4-IgG 和 MOG-IgG。
回顾性、基于人群的队列研究。
基于人群。
2000 年 1 月 1 日至 2018 年 12 月 31 日期间，明尼苏达州奥姆斯特德县所有被诊断为视神经炎的居民。
使用罗切斯特流行病学项目数据库来识别患者。使用活细胞流式细胞术检测血清中的 AQP4-IgG 和 MOG-IgG。主要观察指标是视神经炎的发病率和病因。
110 例患者被诊断为视神经炎，年发病率为 3.9/10 万。最终诊断为 MS 占 57%，特发性占 29%，MOG-IgG 相关疾病占 5%，AQP4-IgG 阳性的视神经脊髓炎谱系障碍（NMOSD）占 3%，感染性占 2%，结节病占 2%，血清阴性 NMOSD 占 1%，药物相关占 1%。3 例 AQP4-IgG 阳性患者均有超过 1 次视神经炎发作，2 例至少 1 只眼无光感。MOG-IgG 阳性患者中，6 例中有 4 例复发视神经炎，所有 6 例视力均恢复到 20/30 或以上。
在人群水平上，AQP4-IgG 和 MOG-IgG 占视神经炎的 9%，与复发性发作有关，但 MOG-IgG 视神经炎的视力预后优于 AQP4-IgG 视神经炎。
