Tachibana Midori, Takano Shunichiro, Ohta Yuri, Shinoda Kei, Yamanouchi Hideo
Ophthalmology, Saitama Medical University, Iruma-gun, JPN.
Pediatrics, Saitama Medical University, Iruma-gun, JPN.
Cureus. 2024 Jul 24;16(7):e65254. doi: 10.7759/cureus.65254. eCollection 2024 Jul.
We report our findings in a 5-year-old Japanese girl with unilateral optic neuritis who was seropositive for anti-myelin-oligodendrocyte glycoprotein (MOG) antibody. Functional and microstructural changes were assessed longitudinally for 3.5 years by serial recordings of the pattern visual evoked potentials (pVEPs) and optical coherence tomography (OCT) during the acute and chronic phases. On the initial visit, the best-corrected visual acuity (BCVA) in the right eye was light perception. She was treated with 450 mg of intravenous methylprednisolone pulses followed by a gradual tapering of the oral prednisolone. The visual acuity decreased to no light perception, and plasmapheresis combined with high-dose intravenous immunoglobulin therapy was performed. The BCVA quickly improved to 1.0, and no recurrence was detected for approximately four years. The implicit times of N75, P100, and N145 of the pVEPs and peripapillary retinal nerve fiber (pRNFL) thickness in the OCT images were measured during the course of the disease process. The pRNFL thickness of the right eye decreased and was less than one-half of the baseline value at one year and then stabilized. In contrast, the optic pathway function assessed by pVEPs improved. The implicit times of the N75 and P100 components of the right eye were shortened and stabilized at approximately one year. However, the implicit times in the right eye were still longer than that of the left eye. Our findings documented the course of the function and structures of an eye with anti-MOG antibody-positive optic neuritis. This information should be helpful for the understanding of the pathology and prognosis of this disease entity. Further analysis of the pVEPs and structural changes in more cases is needed.
我们报告了一名5岁日本女孩的研究结果，该女孩患有单侧视神经炎，抗髓鞘少突胶质细胞糖蛋白（MOG）抗体血清学呈阳性。在急性期和慢性期，通过连续记录图形视觉诱发电位（pVEP）和光学相干断层扫描（OCT），对其功能和微观结构变化进行了3.5年的纵向评估。初诊时，右眼最佳矫正视力（BCVA）为光感。她接受了450毫克静脉注射甲基强的松龙脉冲治疗，随后逐渐减少口服强的松龙剂量。视力下降至无光感，遂进行了血浆置换联合大剂量静脉注射免疫球蛋白治疗。BCVA迅速提高到1.0，大约四年内未检测到复发。在疾病过程中，测量了pVEP的N75、P100和N145的潜伏期以及OCT图像中视乳头周围视网膜神经纤维（pRNFL）厚度。右眼的pRNFL厚度在1年时下降，小于基线值的一半，然后稳定下来。相比之下，通过pVEP评估的视神经通路功能有所改善。右眼N75和P100成分的潜伏期在大约1年时缩短并稳定下来。然而，右眼的潜伏期仍比左眼长。我们的研究结果记录了抗MOG抗体阳性视神经炎患者眼睛的功能和结构变化过程。这些信息有助于理解该疾病实体的病理和预后。需要对更多病例的pVEP和结构变化进行进一步分析。
