Guoji Yanke Zazhi (May 2013)
Analysis on the clinical feature of idiopathic demyelinating optic neuritis and long term follow-up
Abstract
AIM: To investigate the course of disease, clinical characteristic and clinical outcome of patients with idiopathic demyelinating optic neuritis(IDON)in final diagnosis and compare the results with those in western countries. METHODS: Clinical features of 137 cases of IDON with final diagnosis in the General Hospital of Chinese PLA form May 2009 to December 2010 were retrospectively analyzed. RESULTS: With a female to male ratio of 1:1.54, 74 cases had onset in both eyes or one after another, and 63 cases had onset with simple eye. There were 28.9% patients accompanied with oculogyria pain, 69.7% eyes with retrobulbar neuritis and 30.3% eyes with papillitis. There were 58.4% cases with visual acuity recovered to more than 0.5; but there were also 21.8% cases with visual acuity recovered to less than 0.1. The patients in lower age group(≤18 years)had a better recovery of visual acuity and those in higher age group(≥46 year)at the same time had a bad visual acuity. There were significant differences between two groups(P<0.05). There were 89 cases performed aquaporin-4(AQP-4)autoantibodies assay. The results of 28 cases(31.5%)were seropositivity. The patients in seropositivity group had better recovery of visual acuity and there were significant differences compared to seronegativity group. In the two follow-up years, 5 out of 28 seropositive patients were diagnosed as optical neuromyelitis(NMO)and 1 out of 28 was diagnosed as multiple sclerosis(MS)finally; 1 out of 61 seronegative patients were diagnosed as NMO finally. CONCLUSION:Despite of minor differences of clinical feature, the course of IDON is similar to that reported in western countries, AQP-4 autoantibodies may have diagnostic and prognostic value in patients who present with isolated ON. The seropositivity of AQP-4 may mean the worse recovery of sight and increase the chances of the development of NMO.
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