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视神经脊髓炎谱系障碍(NMOSD)相关视神经炎首次发作后患眼视觉预后的预后因素

Prognostic Factors for Visual Outcomes Following the First Episode of NMOSD-Related Optic Neuritis in Affected Eyes.

作者信息

Thongmee Watcharaporn, Padungkiatsagul Tanyatuth, Jindahra Panitha, Khongkhatithum Chaiyos, Thampratankul Lunliya, Vanikieti Kavin

机构信息

Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

出版信息

Clin Ophthalmol. 2020 Dec 4;14:4271-4278. doi: 10.2147/OPTH.S285443. eCollection 2020.

Abstract

OBJECTIVE

We aim to identify prognostic factors for visual outcomes following a first episode of neuromyelitis optica spectrum disorder-related optic neuritis (NMOSD-ON) in affected eyes.

MATERIALS AND METHODS

This was a single-center, retrospective study. The study included 50 individuals who were diagnosed with NMOSD-ON (63 affected eyes) in a tertiary institution over a 12-year period. Data regarding any second, or higher, episodes of NMOSD-ON in each eye were not taken into consideration. Medical records of included individuals were reviewed. Demographic data, clinical and magnetic resonance imaging characteristics, and treatment outcomes were collected. Main outcome measures of the study were prognostic factors for good visual outcome (best-corrected visual acuity (BCVA) ≥ 20/200) following an initial episode of NMOSD-ON in affected eyes.

RESULTS

Sixty-three affected eyes of 50 individuals (3 men and 47 women) were included. BCVA at nadir that was better than counting fingers (CF) (odds ratio 10.43, 95% confidence interval 1.04, 104.45, = 0.046) and time from NMOSD-ON onset to intravenous methylprednisolone (IVMP), less than 21 days (odds ratio 10.73, 95% confidence interval 1.91, 60.01, = 0.007), were significantly associated with good visual outcomes.

CONCLUSION

BCVA at nadir that was better than CF and treatment with IVMP within 21 days of symptom onset were important prognostic factors of good visual outcomes following a first episode of NMOSD-ON in affected eyes.

摘要

目的

我们旨在确定视神经脊髓炎谱系障碍相关视神经炎(NMOSD-ON)首次发作后患眼视力预后的相关因素。

材料与方法

这是一项单中心回顾性研究。该研究纳入了一所三级医疗机构在12年期间诊断为NMOSD-ON的50例患者(63只患眼)。未考虑每只眼中任何第二次或更高次发作的NMOSD-ON的数据。对纳入患者的病历进行了回顾。收集了人口统计学数据、临床和磁共振成像特征以及治疗结果。该研究的主要结局指标是患眼首次发作NMOSD-ON后视力良好(最佳矫正视力(BCVA)≥20/200)的预后因素。

结果

纳入了50例患者(3例男性和47例女性)的63只患眼。最低点时BCVA优于数指(CF)(比值比10.43,95%置信区间1.04,104.45,P = 0.046)以及从NMOSD-ON发作至静脉注射甲泼尼龙(IVMP)的时间小于21天(比值比10.73,95%置信区间1.91,60.01,P = 0.007)与良好的视力预后显著相关。

结论

最低点时BCVA优于CF以及症状发作后21天内接受IVMP治疗是患眼首次发作NMOSD-ON后视力良好的重要预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9166/7723226/d67df3694117/OPTH-14-4271-g0001.jpg

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