Optic disc changes in Chinese patients with -associated autoinflammatory disease.

OBJECTIVE

To investigate the optic disc changes (ODC) in Chinese patients with -associated autoinflammatory disease (-AID).

METHODS

Patients who were diagnosed with -AID at the Department of Rheumatology, Peking Union Medical College Hospital between April 2015 and December 2022 were retrospectively reviewed and analyzed.

RESULTS

A total of 20 patients were enrolled in this retrospective study. All 20 patients had a moderate MWS -AID phenotype. Thirteen patients (65%) had ocular involvements. The interval between symptoms onset and diagnosis was significantly longer in patients with ocular involvement than in patients without ( = 0.044). The incidence of hearing loss was significantly higher in patients with ocular involvement ( = 0.017), while the incidence of abdominal pain was significantly lower when compared to patients without ocular involvement ( = 0.007). Optic disc swelling (ODS) (50%) was the most common ODC. All of the four T348M mutation carriers within our cohort exhibited ODS with visual-field defects. There was a significant difference between patients with/without ODS regarding the number of patients carrying T348M mutation ( = 0.014). The occurrence of hearing loss and CNS involvement was significantly higher in the group with ODS compared to the group without ( = 0.0014,  = 0.0198). Of the eight patients who underwent lumbar puncture, five presented with intracranial hypertension (IH). ODS was observed in all patients with IH. The serum inflammatory markers were significantly higher in patients with ODS than in those without. Two patients receiving regular subcutaneous IL-1 inhibitor treatment showed improvements in ODC.

CONCLUSIONS

ODC is common among Chinese patients with NLRP3-AID, with ODS being the most common manifestation. Hearing loss and CNS involvement often accompany the occurrence of ODS. The serum inflammatory markers are associated with ODS. The T348M mutation is more likely to lead to ODC with visual-field defects.