开始使用类固醇的时间对MOGAD（髓鞘少突胶质细胞糖蛋白抗体相关疾病）中视神经炎的视觉预后有影响。
Time to steroids impacts visual outcome of optic neuritis in MOGAD.
作者信息
Rode Julie, Pique Julie, Maarouf Adil, Ayrignac Xavier, Bourre Bertrand, Ciron Jonathan, Cohen Mikael, Collongues Nicolas, Deschamps Romain, Maillart Elisabeth, Montcuquet Alexis, Papeix Caroline, Ruet Aurelie, Wiertlewski Sandrine, Zephir Helene, Marignier Romain, Audoin Bertrand
机构信息
Service de neurologie, Hôpital de la Timone, APHM, Marseille, France
Service de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron, France.
出版信息
J Neurol Neurosurg Psychiatry. 2023 Apr;94(4):309-313. doi: 10.1136/jnnp-2022-330360. Epub 2022 Dec 13.
BACKGROUND
To characterise the response to treatment of inaugural optic neuritis (ON) in patients with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD).
METHODS
We searched the French MOGAD database for adults with inaugural ON with a detailed report of acute treatment modalities and measures of high-contrast best-corrected visual acuity (BCVA) at nadir and after 3 months. Predictors of visual outcomes were assessed by multivariable analysis.
RESULTS
Among 245 patients with at least one episode of ON, 82 fulfilled all criteria, and data on the peripapillary retinal nerve fibre layer (pRNFL) were available for 44. All patients received methylprednisolone (MP), combined with plasma exchange in 18. After 3 months, 75 of 82 (91%) patients retained full BCVA recovery, and median (range) pRNFL of the affected eye was 72 µm (40-102). Failure to regain 0.0 logarithmic minimum angle of resolution vision (Snellen 20/20) at 3 months was associated with time to first MP treatment ≥10 days (OR 16, 95% CI 1.14 to 213, p=0.01). pRNFL thickness after 3 months was related to better BCVA at nadir and time to first MP treatment <10 days (r2=19%, p=0.004 and r2=11%, p=0.03, respectively).
CONCLUSIONS
Time to MP affects functional but also structural visual outcomes of ON in MOGAD.
背景
描述髓鞘少突胶质细胞糖蛋白抗体相关疾病（MOGAD）患者首次发作视神经炎（ON）的治疗反应。
方法
我们在法国MOGAD数据库中搜索首次发作ON的成人患者，详细报告急性治疗方式以及最低点和3个月后高对比度最佳矫正视力（BCVA）的测量值。通过多变量分析评估视力结果的预测因素。
结果
在245例至少有一次ON发作的患者中，82例符合所有标准，44例患者有视乳头周围视网膜神经纤维层（pRNFL）的数据。所有患者均接受甲基强的松龙（MP）治疗，其中18例联合血浆置换。3个月后，82例患者中有75例（91%）BCVA完全恢复，患眼pRNFL中位数（范围）为72µm（40 - 102）。3个月时未能恢复到0.0对数最小分辨角视力（Snellen 20/20）与首次MP治疗时间≥10天相关（OR 16，95%CI 1.14至213，p = 0.01）。3个月后的pRNFL厚度与最低点时更好的BCVA以及首次MP治疗时间<10天相关（r2分别为19%，p = 0.004和r2为11%，p = 0.03）。
结论
MP治疗时间影响MOGAD中ON的功能和结构视力结果。
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