Terrim Sara, Silva Guilherme Diogo, de Sá E Benevides Falcão Fernando Cavalcanti, Silva Paula Baleeiro Rodrigues, Faria Graziella Aguiar Santos, Filho Flavio Vieira Marques, Piccolo Ana Claudia, Comerlatti Luiz Roberto, de Oliveira Mateus Boaventura, Adoni Tarso, Sato Douglas Kazutoshi, Apóstolos-Pereira Samira Luisa, Callegaro Dagoberto
Neurology Division, Hospital das Clinicas of the University of Sao Paulo, Av Dr. Enéas de Carvalho Aguiar, 255, Sao Paulo 05403-000, Brazil.
Neurology Division, Hospital das Clinicas of the University of Sao Paulo, Av Dr. Enéas de Carvalho Aguiar, 255, Sao Paulo 05403-000, Brazil.
Mult Scler Relat Disord. 2025 Aug;100:106523. doi: 10.1016/j.msard.2025.106523. Epub 2025 May 13.
Neuromyelitis Optica Spectrum Disorder (NMOSD) represents a significant etiology of optic neuritis (ON), primarily due to its severity and risk of sequelae. Early diagnosis is crucial to establish prompt treatment and avoid disability. However, its recognition in acute-phase ON can pose challenges. We aimed to develop a prognostic model for early suspicion of neuromyelitis optica (NMOSD) in patients presenting with ON.
Patients admitted to our emergency department between 2015 and 2020 with diagnosis of ON were enrolled in our study. We performed univariable analysis in our sample to identify variables associated with a final diagnosis of NMOSD. Based on our findings and previous literature, we selected four variables to develop a prognostic model to predict the risk of a diagnosis of NMOSD independent of anti-AQP4 status.
We enrolled 63 participants with optic neuritis (45 women [71 %]; median age 34 years [interquartile range 29-47 years]), of which 18 were diagnosed with NMOSD (12 anti-AQP4 positive and 6 anti-AQP4 negative) and 45 with other demyelinating disease. Our final prognostic model included female gender, bilateral ON, absence of pain, and chiasmal involvement detected in orbit MRI into an NMOON risk score. This score aims to stratify patients into low, intermediate, and high-risk categories for NMOSD among those presenting with ON symptoms.
An easily accessible score with clinical and radiological information may early predict the risk of NMOSD to help in diagnostic and therapeutic decisions.
视神经脊髓炎谱系障碍（NMOSD）是视神经炎（ON）的一个重要病因，主要因其严重性和后遗症风险。早期诊断对于及时开展治疗和避免残疾至关重要。然而，在急性期视神经炎中识别该病可能具有挑战性。我们旨在开发一种预后模型，用于早期怀疑患有视神经炎（ON）的患者中的视神经脊髓炎（NMOSD）。
纳入2015年至2020年间入住我院急诊科且诊断为视神经炎的患者。我们在样本中进行单变量分析，以确定与最终诊断为NMOSD相关的变量。基于我们的研究结果和既往文献，我们选择了四个变量来开发一种预后模型，以预测独立于抗水通道蛋白4（AQP4）状态的NMOSD诊断风险。
我们纳入了63例视神经炎患者（45例女性[71%]；中位年龄34岁[四分位间距29 - 47岁]），其中18例被诊断为NMOSD（12例抗AQP4阳性，6例抗AQP4阴性），45例患有其他脱髓鞘疾病。我们最终的预后模型将女性性别、双侧视神经炎、无疼痛以及眼眶磁共振成像（MRI）检测到的视交叉受累纳入NMOON风险评分。该评分旨在将出现视神经炎症状的患者分为NMOSD的低、中、高风险类别。
一个易于获取的包含临床和放射学信息的评分可能早期预测NMOSD风险，有助于诊断和治疗决策。
