Kemchoknatee Parinee, Singhakul Chotika, Arjkongharn Niracha, Chainakul Methaphon, Tangon Duanghathai, Srisombut Thansit
Department of Ophthalmology, Rajavithi Hospital, Rangsit University, 2 Phaya Thai Rd., Thung Phaya Thai, Ratchathewi, Bangkok 10400, Thailand.
Faculty of Medicine Rajavithi Hospital, Rangsit University, 2 Phaya Thai Rd., Thung Phaya Thai, Ratchathewi, Bangkok 10400, Thailand.
Vision (Basel). 2023 Feb 28;7(1):16. doi: 10.3390/vision7010016.
The clinical characteristics of three types of optic neuritis (double seronegative optic neuritis; DN-ON, Neuromyelitis optica spectrum disorder-related optic neuritis; NMOSD-ON, and multiple sclerosis-related optic neuritis; MS-ON) were examined in order to identify factors that may affect good visual recovery in Thai patients. The study included patients diagnosed with three types of optic neuritis at Rajavithi Hospital between 2011 and 2020. Visual acuity at the end of 12 months was used as the treatment outcome. Multiple logistic regression analysis was used to evaluate potential predictors of good visual recovery. Of the 76 patients, 61 had optic neuritis, with DN-ON as the most common subtype (52.6%). MS-ON patients were significantly younger (28.3 ± 6.6 years, = 0.002) and there was a female predominance in all subgroups ( = 0.076). NMOSD-ON patients had a significantly higher proportion of poor baseline VA ( < 0.001). None of the NMOSD-ON patients achieved 0.3 logMAR visual recovery in the 12-month period ( = 0.022). A delay in treatment with intravenous methylprednisolone (IVMP) for more than 7 days increased the risk of failure to gain 0.3 logMAR visual recovery by five times (OR 5.29, 95% CI 1.359-20.616, = 0.016), with NMOSD-ON as the strongest predictor (OR 10.47, 95% CI; 1.095-99.993, = 0.041). Early treatment with intravenous methylprednisolone may be important for achieving at least 0.3 logMAR visual recovery in Thai patients with optic neuritis.
为了确定可能影响泰国视神经炎患者视力良好恢复的因素，研究了三种类型视神经炎（双血清阴性视神经炎；DN-ON、视神经脊髓炎谱系障碍相关性视神经炎；NMOSD-ON和多发性硬化症相关性视神经炎；MS-ON）的临床特征。该研究纳入了2011年至2020年期间在拉贾维提医院被诊断为三种类型视神经炎的患者。将12个月末的视力作为治疗结果。采用多元逻辑回归分析来评估视力良好恢复的潜在预测因素。在76例患者中，61例患有视神经炎，其中DN-ON是最常见的亚型（52.6%）。MS-ON患者明显更年轻（28.3±6.6岁，P=0.002），且所有亚组均以女性为主（P=0.076）。NMOSD-ON患者基线视力差的比例明显更高（P<0.001）。在12个月期间，没有一例NMOSD-ON患者实现0.3 logMAR视力恢复（P=0.022）。静脉注射甲基强的松龙（IVMP）治疗延迟超过7天会使未能获得0.3 logMAR视力恢复的风险增加五倍（OR 5.29，95%CI 1.359-20.616，P=0.016），其中NMOSD-ON是最强的预测因素（OR 10.47，95%CI；1.095-99.993，P=0.041）。对于泰国视神经炎患者，早期静脉注射甲基强的松龙治疗对于实现至少0.3 logMAR视力恢复可能很重要。
