Aquaporin-4 Serostatus and Visual Outcomes in Clinically Isolated Acute Optic Neuritis

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Title Aquaporin-4 Serostatus and Visual Outcomes in Clinically Isolated Acute Optic Neuritis
Creator Edgar Carnero Contentti; Mariana De Virgiliis; Javier Pablo Hryb; Alejandra Gomez; Sergio Morales; Julia Celso; Felisa Leguizamón; Edson Chiganer; José Luis Di Pace; Carmen Lessa; Mónica Perassolo
Affiliation Department of Neurology (ECC, JPH, AG, SM, JLDP, MP), Hospital Carlos G. Durand, Buenos Aires, Argentina; Neuro-ophthalmology Section (MDV), Hospital P. Lagleyze, Buenos Aires, Argentina; Department of Neurology (JC, FL), Hospital Teodoro Alvarez, Buenos Aires, Argentina; and Department of Immunology and Histocompatibility (EC, CL), Hospital Carlos G. Durand, Buenos Aires, Argentina
Abstract Background: Aquaporin-4 antibodies (AQP4-Ab) are associated with neuromyelitis optica spectrum disorder (NMOSD) and typically this disorder has a poor visual prognosis as a result of optic neuritis (ON). Our aim was to report the clinical features at onset and final visual outcomes at 6 months of patients with ON who were positive for AQP4-Ab vs. those who were negative for AQP4-Ab. Methods: Retrospective cohort study. AQP4-Ab were tested by indirect immunofluorescence in 57 patients with a first episode of ON. All patients initially were referred for consideration of multiple sclerosis ON (MSON), NMOSD, or any other inflammatory central nervous system disorder during follow-up (41.31 ± 24.32 months). Our patients were diagnosed as having NMOSD, MSON, chronic relapsing inflammatory ON, and single isolated ON. Risk factors associated with visual outcomes of ON patients were assessed through an ordinal regression model. Results: Positive AQP4-Ab were associated with male sex (P = 0.02), earlier age of onset (P = 0.01), and myelitis relapses (P = 0.04). Seronegative group had fewer recurrences of ON than the seropositive group (35% vs 58%, P = 0.14). Patients that were positive for AQP4-Ab did not have worse visual acuity at baseline and after 6 months. However, poor visual acuity during first attack was associated with a worse visual acuity at 6 months (odds ratio = 2.28, 95% CI [1.58-3.28], P = 0.03). Conclusions: At 6 months, positive AQP4-Ab vs negative AQP4-Ab patients no evidence of poorer visual acuity. Lower visual acuity at baseline was associated with poor visual recovery at 6 months.
Subject Acute Disease; Adult; Age of Onset; Aquaporin 4 / immunology; Autoantibodies / blood; Disability Evaluation; Female; Fluorescent Antibody Technique, Indirect; Humans; Male; Middle Aged; Neuromyelitis Optica / immunology; Optic Neuritis / immunology; Optic Neuritis / physiopathology; Retrospective Studies; Risk Factors; Seroepidemiologic Studies; Visual Acuity / physiology; Young Adult
OCR Text Show
Date 2019-06
Language eng
Format application/pdf
Type Text
Publication Type Journal Article
Source Journal of Neuro-Ophthalmology, June 2019, Volume 39, Issue 2
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
ARK ark:/87278/s6936hnb
Setname ehsl_novel_jno
ID 1595802
Reference URL https://collections.lib.utah.edu/ark:/87278/s6936hnb
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