Visual field defects of optic neuritis in neuromyelitis optica compared with multiple sclerosis

Nakajima, Hideto; Hosokawa, Takafumi; Sugino, Masakazu; Kimura, Fumiharu; Sugasawa, Jun; Hanafusa, Toshiaki; Takahashi, Toshiyuki

doi:10.1186/1471-2377-10-45

Cited by 69 publications

(55 citation statements)

References 30 publications

(37 reference statements)

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“…The pattern of visual field abnormalities following ON might also be diagnostically relevant. This holds particularly true of altitudinal deficits, which were encountered in NMO (>10% patients), but not in MS 28 29. This type of visual field defect is typical of ischaemic ON and might suggest involvement of vascular mechanisms in the pathogenesis of NMO-associated ON 28 29…”

Section: Clinical Phenotypesmentioning

confidence: 97%

Overlapping CNS inflammatory diseases: differentiating features of NMO and MS

Juryńczyk

Craner

Palace

2014

J Neurol Neurosurg Psychiatry

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Neuromyelitis optica (NMO) has long been considered as a variant of multiple sclerosis (MS) rather than a distinct disease. This concept changed with the discovery of serum antibodies (Ab) against aquaporin-4 (AQP4), which unequivocally differentiate NMO from MS. Patients who test positive for AQP4-Abs and present with optic neuritis (ON) and transverse myelitis (TM) are diagnosed with NMO and those who show an incomplete phenotype with isolated ON or longitudinally extensive TM (LETM) or less commonly brain/brainstem disease are referred to as NMO spectrum disorders (NMOSD). However, many patients, who have overlapping features of both NMO and MS, test negative for AQP4-Abs and may be difficult to definitively diagnose. This raises important practical issues, since NMO and MS respond differently to immunomodulatory treatment and have different prognoses. Here we review distinct features of AQP4-positive NMO and MS, which might then be useful in the diagnosis of antibody-negative overlap syndromes. We identify discriminators, which are related to demographic data (non-white origin, very late onset), clinical features (limited recovery from ON, bilateral ON, intractable nausea, progressive course of disability), laboratory results (cerebrospinal fluid (CSF) pleocytosis with eosinophils and/or neutrophils, oligoclonal bands, glial fibrillary acidic protein in the CSF) and imaging (LETM, LETM with T1 hypointensity, periependymal brainstem lesions, perivenous white matter lesions, Dawson's fingers, curved or S-shaped U-fibre juxtacortical lesions). We review the value of these discriminators and discuss the compelling need for new diagnostic markers in these two autoimmune demyelinating diseases of the central nervous system.

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Section: Clinical Phenotypesmentioning

confidence: 97%

Overlapping CNS inflammatory diseases: differentiating features of NMO and MS

Juryńczyk

Craner

Palace

2014

J Neurol Neurosurg Psychiatry

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“…18 There was a significant reduction of GCL/IPL thickness in both hemifields of ON eye (28.5% and 30.5% reduction, P ϭ 0.0001 and P Ͻ 0.0001 for inferior and superior retina, respectively) ( Table 2). Reduction was significant at all eccentricities for both affected hemifields (P Ͻ 0.02 for all points) (Fig.…”

Section: Multiple Sclerosis Groupmentioning

confidence: 99%

Transsynaptic Retinal Degeneration in Optic Neuropathies: Optical Coherence Tomography Study

Sriram

Graham

Wang³

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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PURPOSE.Recently demonstrated neuronal loss in the inner nuclear layer of the retina in multiple sclerosis (MS) and glaucoma raises the question of a primary (possibly immune-mediated) or secondary (transsynaptic) mechanism of retinal damage in these diseases. In the present study we used optical coherence tomography to investigate retrograde retinal transsynaptic degeneration in patients with long-standing and severe loss of ganglion cells due to optic neuropathy. METHODS. Fifteen eyes of glaucoma patients with visual field defect limited to upper hemifield and 15 eyes of MS patients with previous episode of optic neuritis (ON) and extensive loss of ganglion cells were imaged using spectral-domain optical coherence tomography and compared with two groups of age-matched controls. Combined retinal ganglion cell layer/ inner plexiform layer (GCL/IPL) thickness and inner nuclear layer (INL) thickness were analyzed. RESULTS. In the glaucoma group there was a significant (P ϭ 0.0005) reduction of GCL/IPL thickness in the lower (affected) retina compared with normal controls; however INL thickness was not statistically reduced (P ϭ 0.49). In the MS group reduction of GCL/IPL thickness in both hemifields of ON eyes was also significant (P ϭ 0.0001 and P Ͻ 0.0001 for inferior and superior retina respectively). However, similar to the glaucomatous eyes, there was no significant reduction of INL thickness in both hemifields (P ϭ 0.25 and P ϭ 0.45). CONCLUSIONS. This study demonstrates no significant loss of INL thickness in parts of the retina with long-standing and severe loss of retinal ganglion cells. (Invest Ophthalmol Vis Sci.

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“…On the other hand, in a study by Nakajiuma et al, altitudinal visual defect was also shown to be the most frequent non-central scotom pattern in NMO patients. Based on their results, they suggested possible NMO-IgG mediated ischemic injury as an explanation of ON development in NMO patients [2]. At this point, we would like to state that cranial MRI findings of our patient may add substantial perspectives to these arguments.…”

Section: Case Reportmentioning

confidence: 96%

“…Recently, other disorders such as neuromyelitis optica (NMO) has also been suggested to cause optic neuritis (ON) presenting with altitudinal field defect [2]. Herein, we illustrate clinical and neuroimaging findings of a patient presenting with ON in the form of altitudinal visual field defect who finally received the diagnosis of NMO.…”

Section: Introductionmentioning

confidence: 97%

Optic Neuritis Presenting With Altitudinal Visual Field Defect in a Neuromyelitis Optica Patient

2017

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Herein, we report a case with neuromyelitis optica (NMO) who presented with optic neuritis and visual field examination revealed superior altitudinal visual field defect. Via the presentation of this patient, we point out NMO as an alternative differential diagnosis in patients with altitudinal visual defect clinics. Based on this presentation and literature data, we discuss some hypotheses about pathogenesis of optic neuritis in NMO and underlying mechanisms of optic neuritis development presenting with altitudinal visual defect as well.

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Visual field defects of optic neuritis in neuromyelitis optica compared with multiple sclerosis

Cited by 69 publications

References 30 publications

Overlapping CNS inflammatory diseases: differentiating features of NMO and MS

Overlapping CNS inflammatory diseases: differentiating features of NMO and MS

Transsynaptic Retinal Degeneration in Optic Neuropathies: Optical Coherence Tomography Study

Optic Neuritis Presenting With Altitudinal Visual Field Defect in a Neuromyelitis Optica Patient

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