<p>Prognostic Factors for Visual Outcomes Following the First Episode of NMOSD-Related Optic Neuritis in Affected Eyes</p>

Abstract

Objective: We aim to identify prognostic factors for visual outcomes following a first episode of neuromyelitis optica spectrum disorder-related optic neuritis (NMOSD-ON) in affected eyes. Materials and Methods: This was a single-center, retrospective study. The study included 50 individuals who were diagnosed with NMOSD-ON (63 affected eyes) in a tertiary institution over a 12-year period. Data regarding any second, or higher, episodes of NMOSD-ON in each eye were not taken into consideration. Medical records of included individuals were reviewed. Demographic data, clinical and magnetic resonance imaging characteristics, and treatment outcomes were collected. Main outcome measures of the study were prognostic factors for good visual outcome (best-corrected visual acuity (BCVA) ≥ 20/200) following an initial episode of NMOSD-ON in affected eyes. Results: Sixty-three affected eyes of 50 individuals (3 men and 47 women) were included. BCVA at nadir that was better than counting fingers (CF) (odds ratio 10.43, 95% confidence interval 1.04, 104.45, p = 0.046) and time from NMOSD-ON onset to intravenous methylprednisolone (IVMP), less than 21 days (odds ratio 10.73, 95% confidence interval 1.91, 60.01, p = 0.007), were significantly associated with good visual outcomes. Conclusion: BCVA at nadir that was better than CF and treatment with IVMP within 21 days of symptom onset were important prognostic factors of good visual outcomes following a first episode of NMOSD-ON in affected eyes.

Comparison of Early- and Late-Onset NMOSD-Related Optic Neuritis in Thai Patients: Clinical Characteristics and Long-Term Visual Outcomes

“… 2–4 Moreover, our previously published article, which studied prognostic factors for visual outcomes following the first episode of ON in each affected eye in overall age group of NMOSD-ON patients, showed that a median age at NMOSD-ON onset was 36 years (range 4–84 years). 18 Notably, unlike our previously published article, patients with age < 18 years at NMOSD-ON onset were excluded in this study.…”

“…[2][3][4] Moreover, our previously published article, which studied prognostic factors for visual outcomes following the first episode of ON in each affected eye in overall age group of NMOSD-ON patients, showed that a median age at NMOSD-ON onset was 36 years (range 4-84 years). 18 Notably, unlike our previously published article, patients with age < 18 years at NMOSD-ON onset were excluded in this study. Small proportions of patients in the LO-NMOSD-ON (20%) and EO-NMOSD-ON groups (31.8%) experienced non-ON demyelinating events prior to or concurrent with ON onset; notably, myelitis was the most common event.…”

Chiasmatic lesions on conventional magnetic resonance imaging during the first event of optic neuritis in patients with neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein‐associated disease in a Latin American cohort

“…Additionally, MRI is crucial to exclude differential diagnoses as well as for the evaluation of inflammatory lesions during follow-up [17]. While brain MRI lesions in both NMOSD and MOGAD have been described [9][10][11][12][13][14][15][16][17][18], only a few previous studies have evaluated the radiological features of NMOSD-ON versus MOGAD-ON, focusing on optic chiasm involvement [19][20][21][22][23].…”

“…By contrast, MOGAD-ON is associated with the optic nerve sheath or extends into the orbital fat with gadoliniumenhancing lesions more than half of the length of the optic nerve in 80% of patients [19,24]. Optic chiasm lesions on MRI have been reported in up to 64% of NMOSD-ON patients seropositive for AQP4-ab, while in MOGAD-ON they were reported in up to 16% [19][20][21][22][23]. Thus, frequency rates vary widely between distinct populations worldwide.…”

“…Additionally, MRI is crucial to exclude differential diagnoses as well as for the evaluation of inflammatory lesions during follow‐up [17]. While brain MRI lesions in both NMOSD and MOGAD have been described [9–18], only a few previous studies have evaluated the radiological features of NMOSD‐ON versus MOGAD‐ON, focusing on optic chiasm involvement [19–23]. Typically, NMOSD‐ON affects the posterior segment, often with longitudinally extensive lesions or chiasmal involvement of the optic pathway [1–3].…”