Neuromyelitis Optica Spectrum Disorder: Disease Course and Long-Term Visual Outcome

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Title Neuromyelitis Optica Spectrum Disorder: Disease Course and Long-Term Visual Outcome
Creator Judith Brody, MD, Mark A. Hellmann, MD, Romain Marignier, MD, Itay Lotan, MD, Hadas Stiebel-Kalish, MD
Affiliation Sackler School of Medicine (JB, MAH, IL, HS-K), Tel Aviv University, Tel Aviv, Israel; Neuro-Immunology Service and Department of Neurology (MAH, IL), Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel; Service de Neurologie A (RM), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon-Bron, France; and Neuro-Ophthalmology Unit, Department of Ophthalmology (JB, HS-K), Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
Abstract Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune disease that classically manifests as attacks of optic neuritis (ON) and transverse myelitis (TM). The prevalence, course, and severity of NMOSD vary considerably. Few studies report the neuro-ophthalmologic disease course and visual outcome.; We sought to describe the course and long-term visual outcome in a cohort of NMOSD patients treated in a single tertiary referral center.; The database was searched for all patients with NMOSD who were treated in our center from 2005 to 2014. Data collected included detailed visual outcome, grade of final visual disability, neuroimaging, and results of optical coherence tomography. Details on relapses, acute episodes, and maintenance therapies were recorded.; Of the 12 patients with NMOSD who were followed for a mean duration of 9.06 years, 10 (83%) were women. Mean age at presentation was 33.90 ± 16.94 years. Patients with acute attacks were treated with high-dose intravenous methylprednisolone and offered immunosuppressive maintenance. ON occurred in 18 eyes of 12 patients, with a cumulative total of 37 ON episodes. At the end of the follow-up period, no patient had become legally blind and only 1 patient had lost her driver's license. Pain associated with acute ON was common (83%), whereas optic disc edema was a rare finding in our patient cohort (6%).; In this retrospective series of 12 patients with NMOSD, followed for a mean of 9.06 years, acute-phase treatment was given within 8 days of relapse, followed by maintenance therapy. Functional visual outcome, as measured by the World Health Organization/International Classification of Diseases, Tenth Revision visual disability scale was better than reported in previous studies and driver's license was preserved in 11 of 12 patients. Pain accompanied 83% of ON attacks and may not aid differentiating multiple sclerosis from NMOSD-related ON.
Subject Adolescent; Adult; Older people; Disease Progression; Female; Follow-Up Studies; Humans; Male; Middle Older people; Neuromyelitis Optica; Prognosis; Retrospective Studies; Time Factors; Tomography, Optical Coherence; Vision Disorders; Visual Acuity; Young Adult
OCR Text Show
Date 2016-12
Language eng
Format application/pdf
Type Text
Publication Type Journal Article
Source Journal of Neuro-Ophthalmology, December 2016, Volume 36, Issue 4
Collection Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E SLC, UT 84112-5890
Rights Management © North American Neuro-Ophthalmology Society
ARK ark:/87278/s6p59m1r
Setname ehsl_novel_jno
ID 1293145
Reference URL https://collections.lib.utah.edu/ark:/87278/s6p59m1r
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