K Soelberg1, S Jarius2, Hpb Skejoe3, H Engberg4, J J Mehlsen5, A C Nilsson6, J S Madsen7, M Reindl8, B Wildemann2, J Grauslund9, K O Kyvik10, T J Smith11, S T Lillevang6, F Paul12, B G Weinshenker13, N Asgari14. 1. Departments of Regional Health Research and Molecular Medicine, University of Southern Denmark, Odense, Denmark/Odense Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark/Department of Neurology, Slagelse Hospital, Slagelse, Denmark/Department of Neurology, Lillebaelt Hospital, Vejle, Denmark/Department of Ophthalmology, Odense University Hospital, Odense, Denmark. 2. Molecular Neuroimmunology Group, Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany. 3. Department of Radiology, Aleris-Hamlet Hospital, Copenhagen, Denmark. 4. Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark/Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark. 5. Department of Ophthalmology, Lillebaelt Hospital, Vejle, Denmark. 6. Department of Clinical Immunology, Odense University Hospital, Odense, Denmark. 7. Department of Clinical Immunology and Biochemistry, Lillebaelt Hospital, Vejle, Denmark. 8. Clinical Department of Neurology, Medical University Innsbruck, Innsbruck, Austria. 9. Department of Ophthalmology, Odense University Hospital, Odense, Denmark/Department of Clinical Research, University of Southern Denmark, Odense, Denmark. 10. Odense Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark/Department of Clinical Research, University of Southern Denmark, Odense, Denmark. 11. Departments of Ophthalmology & Visual Sciences and Internal Medicine, Medical School, University of Michigan, Ann Arbor, MI, USA. 12. Clinical and Experimental Multiple Sclerosis Research Center and NeuroCure Clinical Research Center, Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany/Experimental and Clinical Research Center (ECRC), Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Berlin, Germany. 13. Department of Neurology, Mayo Clinic, Rochester, MN, USA. 14. Department of Neurology, Slagelse Hospital, Slagelse, Denmark/Departments of Regional Health Research, Neurobiology and Molecular Medicine, University of Southern Denmark, Odense, Denmark/Odense Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark.
Abstract
BACKGROUND: Optic neuritis (ON) is often associated with multiple sclerosis (MS). Early diagnosis is critical to optimal patient management. OBJECTIVE: To estimate the incidence of acute ON and the rates of conversion to MS and antibody-mediated ON. METHOD: Population-based prospective study was performed in patients with ON from three ophthalmological departments and 44 practicing ophthalmologists from 2014 to 2016. Ophthalmological and neurological examination, magnetic resonance imaging (MRI), determination of aquaporin-4(AQP4)-IgG and myelin-oligodendrocyte glycoprotein (MOG)-IgG were investigated blindly. RESULTS: In all, 63 patients were evaluated and 51 fulfilled the criteria for ON. All were Caucasian, with female:male ratio of 2.2:1 and a median age of 38 years (16-66); 44 (86%) had a single episode of ON (four bilateral), while 7/51 (14%) had recurrent ON. The overall age-specific incidence was 3.28 (2.44-4.31) per 100,000 person years, 2.02 for men and 4.57 for women. At follow-up, 20 patients met the diagnostic criteria for MS, MRI lesions disseminated in space and time in 17/20 patients. AQP4-IgG was detected in none, MOG-IgG was detected in two patients. CONCLUSION: The prospective incidence of ON was estimated. MRI enabled a diagnosis of MS in a subgroup of patients. Antibody-mediated ON with specificity for MOG was detected in 4% of cases.
BACKGROUND:Optic neuritis (ON) is often associated with multiple sclerosis (MS). Early diagnosis is critical to optimal patient management. OBJECTIVE: To estimate the incidence of acute ON and the rates of conversion to MS and antibody-mediated ON. METHOD: Population-based prospective study was performed in patients with ON from three ophthalmological departments and 44 practicing ophthalmologists from 2014 to 2016. Ophthalmological and neurological examination, magnetic resonance imaging (MRI), determination of aquaporin-4(AQP4)-IgG and myelin-oligodendrocyte glycoprotein (MOG)-IgG were investigated blindly. RESULTS: In all, 63 patients were evaluated and 51 fulfilled the criteria for ON. All were Caucasian, with female:male ratio of 2.2:1 and a median age of 38 years (16-66); 44 (86%) had a single episode of ON (four bilateral), while 7/51 (14%) had recurrent ON. The overall age-specific incidence was 3.28 (2.44-4.31) per 100,000 person years, 2.02 for men and 4.57 for women. At follow-up, 20 patients met the diagnostic criteria for MS, MRI lesions disseminated in space and time in 17/20 patients. AQP4-IgG was detected in none, MOG-IgG was detected in two patients. CONCLUSION: The prospective incidence of ON was estimated. MRI enabled a diagnosis of MS in a subgroup of patients. Antibody-mediated ON with specificity for MOG was detected in 4% of cases.
Authors: John J Chen; Elias S Sotirchos; Amanda D Henderson; Eleni S Vasileiou; Eoin P Flanagan; M Tariq Bhatti; Sepideh Jamali; Eric R Eggenberger; Marie Dinome; Larry P Frohman; Anthony C Arnold; Laura Bonelli; Nicolas Seleme; Alvaro J Mejia-Vergara; Heather E Moss; Tanyatuth Padungkiatsagul; Hadas Stiebel-Kalish; Itay Lotan; Mark A Hellmann; Dave Hodge; Frederike Cosima Oertel; Friedemann Paul; Shiv Saidha; Peter A Calabresi; Sean J Pittock Journal: Mult Scler Relat Disord Date: 2022-01-11 Impact factor: 4.339
Authors: Mohamed B Hassan; Caroline Stern; Eoin P Flanagan; Sean J Pittock; Amy Kunchok; Robert C Foster; Jiraporn Jitprapaikulsan; David O Hodge; M Tariq Bhatti; John J Chen Journal: Am J Ophthalmol Date: 2020-07-21 Impact factor: 5.258