Neuromyelitis optica: clinical features, immunopathogenesis and treatment

Jarius, Sven; Wildemann, Brigitte; Paul, Friedemann

doi:10.1111/cei.12271

Cited by 312 publications

(254 citation statements)

References 288 publications

(613 reference statements)

Supporting

Mentioning

230

Contrasting

Unclassified

Order By: Relevance

“…ON is often associated with demyelinating disorders such as multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) (Jarius, Wildemann, & Paul, 2014; Oertel et al., 2017). The prognosis for visual recovery is generally good but contrast sensitivity and color vision are rarely normal, especially in patients with MS (Beck et al., 2004; Cole, Beck, Moke, Gal, & Long, 2000; Fleishman, Beck, Linares, & Klein, 1987).…”

Section: Introductionmentioning

confidence: 99%

Time to steroid treatment in severe acute optic neuritis

et al. 2018

View full text Add to dashboard Cite

ObjectivesSteroid treatment can accelerate visual recovery in patients with optic neuritis (ON), but it is unknown whether the timing of the start of treatment influences the outcome. The main purpose of this observational study was to assess the effect of early onset steroid treatment of ON on visual prognosis and retinal morphology.MethodsForty‐nine patients with acute mild/moderate (n = 21) or severe (n = 28) ON, and an equal number of healthy controls were enrolled. Patients with severe ON either received early onset steroid treatment (initiated within 1 week of presentation with visual loss) (n = 9), late‐onset treatment (initiated after 1 week) (n = 13), or no treatment (n = 6). Visual function and retinal morphology was studied after 6 and 12 months.ResultsAll measures of visual function had improved after 6 months (p ≤ 0.03) in the three groups with severe ON. This was not the case for Rayleigh match setting range (SR) in the nontreated group (p = 0.24), or for SR (p = 0.08) and latency to P100 of visual evoked potential (p = 0.08) in the late‐onset treated group. After 12 months, further improvement occurred in the nontreated and late‐treated groups, but not in the early treated group. Macular retinal nerve fiber layer (mRNFL) and ganglion cell plus inner plexiform layer had decreased significantly (p ≤ 0.001) in all three groups with severe ON after 6 months. After 12 months, only mRNFL had further significantly decreased and only in the late‐onset treated group (p = 0.02).ConclusionThe beneficial effects of early onset steroid treatment of ON is limited to a few months whereas the long‐term prognosis is independent of the timing of treatment.

show abstract

Section: Introductionmentioning

confidence: 99%

Time to steroid treatment in severe acute optic neuritis

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Over one third of multiple sclerosis (MS) patients experience persistent visual symptoms [1]. Optic neuritis (ON) is among most frequent symptoms in MS [1][2][3] and a core clinical characteristic in neuromyelitis optica spectrum disorders (NMOSD) [4,5].…”

Section: Introductionmentioning

confidence: 99%

Diffusion tensor imaging for multilevel assessment of the visual pathway: possibilities for personalized outcome prediction in autoimmune disorders of the central nervous system

et al. 2017

View full text Add to dashboard Cite

The afferent visual pathway represents the most frequently affected white matter pathway in multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD). Diffusion tensor imaging (DTI) can reveal microstructural or non-overt brain tissue damage and quantify pathological processes. DTI facilitates the reconstruction of major white matter fiber tracts allowing for the assessment of structure-function and damage-dysfunction relationships. In this review, we outline DTI studies investigating the afferent visual pathway in idiopathic optic neuritis (ON), NMOSD, and MS. Since MS damage patterns are believed to depend on multiple factors, i.e., ON (anterior visual pathway damage), inflammatory lesions (posterior visual pathway damage), and global diffuse inflammatory and neurodegenerative processes, comprehensive knowledge on different contributing factors using DTI in vivo may advance our understanding of MS disease pathology. Combination of DTI measures and visual outcome parameters yields the potential to improve routine clinical diagnostic procedures and may further the accuracy of individual prognosis with regard to visual function and personalized disease outcome. However, due to the inherent limitations of DTI acquisition and post-processing techniques and the so far heterogeneous and equivocal data of previous studies, evaluation of the true potential of DTI as a possible biomarker for afferent visual pathway dysfunction is still substantially limited. Further research efforts with larger longitudinal studies and standardized DTI acquisition and post-processing validation criteria are needed to overcome current DTI limitations. DTI evaluation at different levels of the visual pathway has the potential to provide markers for individual damage evaluation in the future. As an imaging biomarker, DTI may support individual outcome prediction during personalized treatment algorithms in MS and other neuroinflammatory diseases, hereby leveraging the concept of predictive, preventive, and personalized medicine in the field of clinical neuroimmunology.

show abstract

“…Neuromyelitis optica spectrum disorders (NMOSD) are often disabling neuroinflammatory, autoimmune central nervous system conditions predominantly affecting the spinal cords and optic nerves [1][2][3][4]. Prior to the discovery of a serum immunoglobulin G antibody targeting the aquaporine-4 water channel [5,6], it was often considered a variant of multiple sclerosis (MS) as the clinical presentation of these two distinct central nervous system (CNS) diseases may overlap [1].…”

Section: Introductionmentioning

confidence: 99%

Neuromyelitis optica does not impact periventricular venous density versus healthy controls: a 7.0 Tesla MRI clinical study

Schumacher

Pache

Bellmann‐Strobl

et al. 2016

Magn Reson Mater Phy

View full text Add to dashboard Cite

Object:To quantify the periventricular venous density in neuromyelitis optica spectrum disease (NMOSD) in comparison to multiple sclerosis (MS) and healthy control subjects. Materials and Methods:Sixteen NMOSD, sixteen MS and sixteen healthy control subjects (HC) underwent 7.0 Tesla (7T) MRI. The imaging protocol included T 2 * weighted (T2*w) fast low angle shot (FLASH) and fluid attenuated inversion recovery (FLAIR) sequences. The periventricular venous area (PVA) was manually determined by a blinded investigator in order to estimate the periventricular venous density in a region-of-interest based approach. Results:No significant differences in periventricular venous density indicated by PVA were detectable in NMOSD versus healthy controls (p=0.226). In contrast, PVA was significantly reduced in MS patients compared to HC (p=0.013). Conclusion:Unlike in MS, patients suffering from NMOSD did not show a reduced venous visibility.This finding may underscore primary and secondary pathophysiological differences between these two distinct diseases of the central nervous system. 5

show abstract

Neuromyelitis optica: clinical features, immunopathogenesis and treatment

Cited by 312 publications

References 288 publications

Time to steroid treatment in severe acute optic neuritis

Time to steroid treatment in severe acute optic neuritis

Diffusion tensor imaging for multilevel assessment of the visual pathway: possibilities for personalized outcome prediction in autoimmune disorders of the central nervous system

Neuromyelitis optica does not impact periventricular venous density versus healthy controls: a 7.0 Tesla MRI clinical study

Contact Info

Product

Resources

About