Optical coherence tomography in acute optic neuritis: A population-based study

Soelberg, Kerstin; Specovius, Svenja; Zimmermann, Hanna; Grauslund, Jakob; Mehlsen, Jesper; Olesen, Clement; Neve, Allan S B; Paul, Friedemann; Brandt, Alexander U.; Asgari, Nasrin

doi:10.1111/ane.13004

Cited by 46 publications

(33 citation statements)

References 33 publications

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“…So, other objective evidence such as OCT or visualevoked potential that could have assisted the diagnosis could not be reviewed. 47 The strengths of our study included its nationwide large sample size, strictly defined diagnosis criteria, and additional registration codes for intractable diseases including MS and NMO, which are thought to be highly reliable.…”

Section: Study Limitationsmentioning

confidence: 99%

Population-based Incidence of Pediatric and Adult Optic Neuritis and the Risk of Multiple Sclerosis

et al. 2020

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Purpose: To determine the age-and sex-specific prevalence and incidence of demyelinating optic neuritis and the risk of multiple sclerosis (MS) in pediatric and adult populations in South Korea. Design: A nationwide, population-based, retrospective study using data from the Korean National Health Claims database from 2010 to 2016. Participants: The entire South Korean population aged 65 years of age or younger (n ¼ 44 700 564). All patients with optic neuritis from the entire Korean population were included. Methods: Patients aged 14 years of age or younger were classified as pediatric patients, and those aged 15 to 65 years were classified as adults. Each group was analyzed separately. Patients with optic neuritis had a subsequent diagnosis, including idiopathic, MS, neuromyelitis optica (NMO), and acute disseminated encephalomyelitis. Prevalence and incidence, conversion rate to MS, and treatment modalities (steroids, plasmapheresis, interferon-b, and immunosuppressants) were estimated. Main Outcome Measures: Prevalence and incidence of optic neuritis, and conversion rate to MS. Results: Among 44 700 564 individuals, 531 pediatric patients (50.7% female) and 7183 adults (53.3% female) were identified as having optic neuritis. Annual incidence was 1.04 (95% confidence interval [CI], 1.01e1.07) per 100 000 pediatric individuals and 3.29 (95% CI, 3.28e3.30) per 100 000 adults. Peak incidence was observed at 10 to 14 years in the pediatric population and at 30 to 34 years and 50 to 54 years in the adult population. Conversion rate to MS was 13.8% in the pediatric population and 11.4% in the adult population. Fourteen percent of all patients were treated with chronic immunosuppressants, 38% of patients with NMO underwent plasmapheresis, and 50% of patients with MS were treated with interferon-b. Conclusions: This is a nationwide epidemiologic study of optic neuritis in individuals of all ages in South Korea. The incidence of optic neuritis and subsequent risk of MS in the pediatric population are comparable to those reported in western countries but are lower in the adult population than in western countries. The incidence rate in adults was 3.2-fold higher than in the pediatric population, and the overall MS conversion rate in the entire Korean population was estimated to be 10.6%. Ophthalmology 2020;127:417-425 ª 2019 by the American Academy of Ophthalmology

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Section: Study Limitationsmentioning

confidence: 99%

Population-based Incidence of Pediatric and Adult Optic Neuritis and the Risk of Multiple Sclerosis

et al. 2020

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“…Post-inflammatory retinal atrophy is an expected outcome after ON [76]. GCIPLV loss may start as early as 8 days after ON onset [77], and RNFL thinning has been reported as early as after 1 month, being predictive of progressive atrophy at month 6 [78]. Increased RNFLT due to edematous swelling, which may be present in the hyperacute state [79], was not observed.…”

Section: Discussionmentioning

confidence: 94%

Fingolimod after a first unilateral episode of acute optic neuritis (MOVING) – preliminary results from a randomized, rater-blind, active-controlled, phase 2 trial

et al. 2020

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Background: Neuroprotection and promotion of remyelination represent important therapeutic gaps in multiple sclerosis (MS). Acute optic neuritis (ON) is a frequent MS manifestation. Based on the presence and properties of sphingosine-1-phosphate receptors (S1PR) on astrocytes and oligodendrocytes, we hypothesized that remyelination can be enhanced by treatment with fingolimod, a S1PR modulator currently licensed for relapsing-remitting MS. Methods: MOVING was an investigator-driven, rater-blind, randomized clinical trial. Patients with acute unilateral ON, occurring as a clinically isolated syndrome or MS relapse, were randomized to 6 months of treatment with 0.5 mg oral fingolimod or subcutaneous IFN-β 1b 250 μg every other day. The change in multifocal visual evoked potential (mfVEP) latency of the qualifying eye was examined as the primary (month 6 vs. baseline) and secondary (months 3, 6 and 12 vs. baseline) outcome. In addition, full field visual evoked potentials, visual acuity, optical coherence tomography as well as clinical relapses and measures of disability, cerebral MRI, and self-reported visual quality of life were obtained for follow-up. The study was halted due to insufficient recruitment (n = 15), and available results are reported.Results: Per protocol analysis of the primary endpoint revealed a significantly larger reduction of mfVEP latency at 6 months compared to baseline with fingolimod treatment (n = 5; median decrease, 15.7 ms) than with IFN-β 1b treatment (n = 4; median increase, 8.15 ms) (p < 0.001 for interaction). Statistical significance was maintained in the secondary endpoint analysis. Descriptive results are reported for other endpoints. Conclusion: Preliminary results of the MOVING trial argue in support of a beneficial effect of fingolimod on optic nerve remyelination when compared to IFN-β treatment. Interpretation is limited by the small number of complete observations, an unexpected deterioration of the control group and a difference in baseline mfVEP latencies. The findings need to be confirmed in larger studies.Trial registration: The trial was registered as EUDRA-

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“…ON is characterized by in ammatory demyelination and axonal injury in the optic nerve, leading to RGC loss and visual dysfunction (26). ON commonly occurs in MS patients and in its animal model, EAE, as well (8).…”

Section: Discussionmentioning

confidence: 99%

Matrine protects retinal ganglion cells from apoptosis in experimental optic neuritis

Kang¹,

Liu²,

Song³

et al. 2020

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Background: Inflammatory demyelination and axonal injury of the optic nerve are hallmarks of optic neuritis (ON), which often occurs in multiple sclerosis and is a major cause of visual disturbance in young adults. Although a high dose of corticosteroids can promote visual recovery, it cannot prevent permanent neuronal damage. Novel and effective therapies are thus required. Given the recently defined capacity of matrine (MAT), a quinolizidine alkaloid derived from the herb Radix Sophorae flavescens, in immunomodulation and neuroprotection, we tested in this study the effect of matrine on rats with experimental autoimmune encephalomyelitis, an animal model of multiple sclerosis. Results: MAT administration, started at disease onset, significantly suppressed optic nerve infiltration and demyelination, with reduced numbers of Iba1 + macrophages/microglia and CD4 + T cells, compared to those from vehicle-treated rats. Increased expression of neurofilaments, an axon marker, reduced numbers of apoptosis in retinal ganglion cells (RGCs), and reduced numbers of Iba1 + macrophages/microglia and CD4 + T cells were also observed in the retina after MAT treatment. Conclusions: Taken as a whole, our results demonstrate that MAT attenuated inflammation, demyelination and axonal loss in the optic nerve, and protected RGCs from inflammation-induced cell death. MAT may therefore have potential as a novel treatment for this disease that may result in blindness.

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Optical coherence tomography in acute optic neuritis: A population-based study

Abstract: Optic neuritis causes substantial retinal damage and vision loss independent of the underlying disease. Our study supports that GCIP damage starts closely to clinical onset. Good structure-function correlations between OCT and vision support the importance of OCT in monitoring acute ON.

Cited by 46 publications

References 33 publications

Population-based Incidence of Pediatric and Adult Optic Neuritis and the Risk of Multiple Sclerosis

Population-based Incidence of Pediatric and Adult Optic Neuritis and the Risk of Multiple Sclerosis

Fingolimod after a first unilateral episode of acute optic neuritis (MOVING) – preliminary results from a randomized, rater-blind, active-controlled, phase 2 trial

Matrine protects retinal ganglion cells from apoptosis in experimental optic neuritis

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