Risk of central nervous system demyelinating attack or optic neuritis recurrence after pediatric optic neuritis in Korea

被引:2
|
作者
Moon, Yeji [1 ]
Park, Kyung-Ah [2 ]
Han, Jinu [3 ]
Hwang, Jeong-Min [4 ]
Kim, Seong-Joon [5 ]
Han, Sueng-Han [6 ]
Lee, Byung Joo [1 ]
Kang, Min Chae [2 ]
Goh, Yong Hyu [2 ]
Lim, Byung Chan [7 ]
Yang, Hee Kyung [4 ]
Jung, Jae Ho [5 ]
机构
[1] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Ophthalmol, Seoul, South Korea
[2] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Ophthalmol, Seoul, South Korea
[3] Yonsei Univ, Coll Med, Gangnam Severance Hosp, Dept Ophthalmol,Inst Vis Res, Seoul, South Korea
[4] Seoul Natl Univ, Bundang Hosp, Dept Ophthalmol, Coll Med, 82 Gumi Ro, 173 Beon Gil, Seongnam Si 13620, Gyeonggi Do, South Korea
[5] Seoul Natl Univ, Seoul Natl Univ Hosp, Dept Ophthalmol, Coll Med, 101 Daehak Ro, Seoul 03080, South Korea
[6] Yonsei Univ, Coll Med, Severance Hosp, Dept Ophthalmol,Inst Vis Res, Seoul, South Korea
[7] Seoul Natl Univ, Coll Med, Childrens Hosp, Dept Pediat, Seoul, South Korea
关键词
Pediatric optic neuritis; Aquaporin-4 immunoglobulin G; Neuromyelitis optica spectrum disorder; Myelin oligodendrocyte glycoprotein antibody; Multiple sclerosis; MYELIN OLIGODENDROCYTE GLYCOPROTEIN; MULTIPLE-SCLEROSIS; CLINICAL-FEATURES; ANTIBODIES; MRI; ABNORMALITIES; SPECTRUM; OUTCOMES;
D O I
10.1007/s10072-023-07125-9
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Purpose To investigate the rate of development of symptomatic central nervous system (CNS) demyelinating attacks or recurrent optic neuritis (ON) after the first episode of ON and its risk factors for Korean pediatric patients.Methods This multicenter retrospective cohort study included the patients under 18 years of age (n=132) diagnosed with ON without previous or simultaneous CNS demyelinating diseases. We obtained the clinical data including the results of neuro-ophthalmological examinations, magnetic resonance images (MRIs), antibody assays, and laboratory tests. We investigated the chronological course of demyelinating disease with respect to the occurrence of neurological symptoms and/or signs, and calculated the 5-year cumulative probability of CNS demyelinating disease or ON recurrence. ResultsDuring the follow-up period (63.1 +/- 46.7 months), 18 patients had experienced other CNS demyelinating attacks, and the 5-year cumulative probability was 14.0 +/- 3.6%. Involvement of the extraorbital optic nerve or optic chiasm and asymptomatic lesions on the brain or spinal MRI at initial presentation were significant predictors for CNS demyelinating attack after the first ON. The 5-year cumulative probability of CNS demyelinating attack was 44.4 +/- 24.8% in the AQP4-IgG group, 26.2 +/- 11.4% in the MOG-IgG group, and 8.7 +/- 5.9% in the double-negative group (P=0.416). Thirty-two patients had experienced a recurrence of ON, and the 5-year cumulative probability was 24.6 +/- 4.0%. In the AQP4-IgG group, the 5-year cumulative probability was 83.3 +/- 15.2%, which was significantly higher than in the other groups (P<0.001).ConclusionsA careful and multidisciplinary approach including brain/spinal imaging and antibody assay can help predict further demyelinating attacks in pediatric ON patients.
引用
收藏
页码:1173 / 1183
页数:11
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