OBJECTIVE: To describe the clinical characteristics, course, and prognosis of optic neuritis in recurrent neuromyelitis optica. METHODS: We analyzed 60 patients diagnosed using 1999 Mayo Clinic criteria who were seen between 1985 and 2004 at Hospital da Lagoa (Rio de Janeiro, Brazil). RESULTS: Optic neuritis was the initial feature in 53.3% of patients, most with unilateral disease. Recurrent optic neuritis before myelitis occurred in 18.3%. The visual impairment was severe at nadir of the visual index event in 78.3%, with a high remission rate. In the median disease duration of 8 years (range, 0.5-30 years), 380 relapses (118 optic neuritis, 223 myelitis, 39 optic neuritis and myelitis) occurred. At the last follow-up, 53.3% of patients had bilateral visual impairment and 63.3% were blind in at least 1 eye. A high mortality rate (23.3%) was due to cervical myelitis. Mortality rates were significantly higher among Afro Brazilian patients (58.3%). CONCLUSIONS: Optic neuritis in patients with recurrent neuromyelitis optica has a severe and acute onset, with predominantly unilateral lesions followed by improvement of clinical symptoms. In the long-term, the disease leads to severe bilateral visual impairment. Mortality rates are higher among patients of Afro Brazilian descent.
OBJECTIVE: To describe the clinical characteristics, course, and prognosis of optic neuritis in recurrent neuromyelitis optica. METHODS: We analyzed 60 patients diagnosed using 1999 Mayo Clinic criteria who were seen between 1985 and 2004 at Hospital da Lagoa (Rio de Janeiro, Brazil). RESULTS:Optic neuritis was the initial feature in 53.3% of patients, most with unilateral disease. Recurrent optic neuritis before myelitis occurred in 18.3%. The visual impairment was severe at nadir of the visual index event in 78.3%, with a high remission rate. In the median disease duration of 8 years (range, 0.5-30 years), 380 relapses (118 optic neuritis, 223 myelitis, 39 optic neuritis and myelitis) occurred. At the last follow-up, 53.3% of patients had bilateral visual impairment and 63.3% were blind in at least 1 eye. A high mortality rate (23.3%) was due to cervical myelitis. Mortality rates were significantly higher among Afro Brazilian patients (58.3%). CONCLUSIONS:Optic neuritis in patients with recurrent neuromyelitis optica has a severe and acute onset, with predominantly unilateral lesions followed by improvement of clinical symptoms. In the long-term, the disease leads to severe bilateral visual impairment. Mortality rates are higher among patients of Afro Brazilian descent.
Authors: Mkael Symmonds; Niranjanan Nirmalananthan; Graham P Taylor; Leslie R Bridges; Frederick Schon Journal: J Neurol Date: 2012-08-24 Impact factor: 4.849
Authors: Eric D Gaier; Katherine Boudreault; Joseph F Rizzo; Julie Falardeau; Dean M Cestari Journal: Curr Neurol Neurosci Rep Date: 2015-12 Impact factor: 5.081
Authors: Ulisses C Linhares; Patrícia B Schiavoni; Priscila O Barros; Taissa M Kasahara; Bruna Teixeira; Thais B Ferreira; Regina Alvarenga; Joana Hygino; Morgana M M Vieira; Vera Carolina B Bittencourt; Regis M Andrade; Arnaldo F Andrade; Cleonice A M Bento Journal: J Clin Immunol Date: 2012-09-05 Impact factor: 8.317