视神经炎
髓鞘少突胶质细胞糖蛋白
多发性硬化
医学
视神经
视神经脊髓炎
水通道蛋白4
病变
视束
病理
磁共振成像
眼科
放射科
免疫学
实验性自身免疫性脑脊髓炎
作者
Sudarshini Ramanathan,Kristina Prelog,Elizabeth H Barnes,Esther Tantsis,Stephen W. Reddel,Andrew Henderson,Steve Vucic,Mark Gorman,Leslie Benson,Gülay Alper,Catherine J. Riney,Michael Barnett,John Parratt,Todd A. Hardy,Richard J. Leventer,Vera Merheb,Margherita Nosadini,Victor S.C. Fung,Fabienne Brilot,Russell C. Dale
标识
DOI:10.1177/1352458515593406
摘要
Background: Recognizing the cause of optic neuritis (ON) affects treatment decisions and visual outcomes. Objective: We aimed to define radiological features of first-episode demyelinating ON. Methods: We performed blinded radiological assessment of 50 patients presenting with first-episode myelin oligodendrocyte glycoprotein (MOG) antibody-associated ON (MOG-ON; n=19), aquaporin-4 (AQP4) antibody-associated ON (AQP4-ON; n=11), multiple sclerosis (MS)-associated ON (MS-ON; n=13), and unclassified ON ( n=7). Results: Bilateral involvement was more common in MOG-ON and AQP4-ON than MS-ON (84% vs. 82% vs. 23%), optic nerve head swelling was more common in MOG-ON (53% vs. 9% vs. 0%), chiasmal involvement was more common in AQP4-ON (5% vs. 64% vs. 15%), and bilateral optic tract involvement was more common in AQP4-ON (0% vs. 45% vs. 0%). Retrobulbar involvement was more common in MOG-ON, whereas intracranial involvement was more common in AQP4-ON. MOG-ON and AQP4-ON had longer lesion lengths than MS-ON. The combination of two predictors, the absence of magnetic resonance imaging brain abnormalities and a higher lesion extent score, showed a good ability to discriminate between an autoantibody-associated ON (MOG or AQP4) and MS. AQP4-ON more frequently had severe and sustained visual impairment. Conclusion: MOG-ON and AQP4-ON are more commonly bilateral and longitudinally extensive. MOG-ON tends to involve the anterior optic pathway, whereas AQP4-ON the posterior optic pathway.
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