Clinical Ophthalmology (Sep 2020)

Etiologies of Acute Optic Neuritis in Thailand: An Observational Study of 171 Patients

  • Vanikieti K,
  • Janyaprasert P,
  • Lueangram S,
  • Nimworaphan J,
  • Rattanathamsakul N,
  • Tiraset N,
  • Chokthaweesak W,
  • Samipak N,
  • Padungkiatsagul T,
  • Preechawat P,
  • Poonyathalang A,
  • Pulkes T,
  • Tunlayadechanont S,
  • Siriyotha S,
  • Jindahra P

Journal volume & issue
Vol. Volume 14
pp. 2935 – 2942

Abstract

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Kavin Vanikieti,1 Pavarut Janyaprasert,1 Sirin Lueangram,1 Jirat Nimworaphan,1 Natthapon Rattanathamsakul,1 Nanida Tiraset,1 Wimonwan Chokthaweesak,1 Narong Samipak,1 Tanyatuth Padungkiatsagul,1 Pisit Preechawat,1 Anuchit Poonyathalang,1 Teeratorn Pulkes,2 Supoch Tunlayadechanont,2 Sukanya Siriyotha,3 Panitha Jindahra2 1Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand; 2Division of Neurology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand; 3Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, ThailandCorrespondence: Panitha JindahraDivision of Neurology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Thung Phaya Thai, Ratchathewi, Bangkok 10400, ThailandTel +6622011386Email [email protected]: To analyze the demographic patterns, clinical characteristics and etiologies of acute optic neuritis (ON).Methods: This retrospective observational study included patients with acute ON who presented to a university hospital in Bangkok, Thailand, between January 2010 and March 2020. The demographic details, clinical characteristics and etiologies of acute ON were evaluated.Results: A total of 171 patients were included in the study (78.4% [n=134] female; mean age 45 years [standard deviation 15.4 years]; 32.2% [n=55] bilateral involvement). The most common type of acute ON was idiopathic (51.5%), followed by neuromyelitis optica spectrum disorder (NMOSD, 30.9%), other autoimmune disorders (9.9%), myelin oligodendrocyte glycoprotein antibody-associated disorder (MOGAD, 5.3%), multiple sclerosis (MS, 1.8%), and postinfection (0.6%). In the other autoimmune disorders group, 2 patients developed systemic lupus erythematosus (1.2%), 2 Sjogren’s syndrome (1.2%), 1 RA (0.6%), 1 anti-NMDAR (0.6%), 3 anti-Jo1 (1.8%), 2 c-ANCA (1.2%), 1 anti-centromere (0.6%), and 5 nonspecific autoimmune disorders (2.9%). In the idiopathic group, 38.6% developed single isolated ON, 1.8% relapsing isolated ON and 11.1% chronic relapsing inflammatory optic neuropathy.Conclusion: The most common form of acute ON in this study, similar to other Asian countries, was idiopathic. Idiopathic-ON shared some phenotypes with NMOSD and MOGAD. We also reported patients with anti-NMDAR, anti-Jo1, c-ANCA and anti-centromere disorders. Improvements in antibody detection have widened the range of possible etiologies of acute ON. The study highlighted the important role of antibodies in creating effective treatments in the future.Keywords: optic neuritis, multiple sclerosis, neuromyelitis optica spectrum disorder, myelin oligodendrocyte glycoprotein antibody-associated disorder, autoimmune disorders, postinfection

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