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Visual function and inner retinal structure correlations in aquaporin-4 antibody-positive optic neuritis

  • Nattapong Mekhasingharak
  • Niphon Chirapapaisan
  • Poramaet Laowanapiban
  • Sasitorn Siritho
  • Naraporn Prayoonwiwat
  • Chanjira Satukijchai
  • Jiraporn Jitprapaikulsan
  • Pornsawan Mekhasingharak
  • Siriraj Neuroimmunology Research Group
Clinical Investigation
  • 26 Downloads

Abstract

Purpose

To investigate the correlation between visual function and thinning of the retinal nerve fiber layer (RNFL) and the macular ganglion cell-inner plexiform layer (GCIPL) as measured by optical coherence tomography (OCT) in eyes with aquaporin-4 IgG-positive optic neuritis (AQP4-IgG-positive ON).

Study design

Prospective study.

Methods

Patients with a history of ON were categorized into 2 groups: the AQP4-IgG-positive group and the AQP4-IgG-negative group. Patients with multiple sclerosis were excluded. All patients underwent ophthalmologic examination and OCT imaging at least 6 months after the last episode of acute ON. Visual function and inner retinal structure correlations were analyzed using Pearson correlation and regression analyses.

Results

Thirty-one previous ON eyes of 17 AQP4-IgG-positive patients and 21 previous ON eyes of 15 AQP4-IgG-negative patients were registered. Visual function, especially the visual field, was better correlated with RNFL than with macular GCIPL. The best correlation between visual function and RNFL was the linear model, whereas the best correlation between visual function and GCIPL was the nonlinear model (inverse regression). Regression models revealed worse visual function in AQP4-IgG-positive ON than in AQP4-IgG-negative ON, whereas no differences in RNFL and GCIPL were found between the 2 groups.

Conclusions

RNFL measured by OCT can be a useful retinal structure for estimating and monitoring visual field loss in AQP4-IgG-positive ON patients, particularly in patients whose visual field cannot be quantitated. The correlation between visual function and the inner retinal structure of eyes with AQP4-IgG is unique and differs from that of eyes without AQP4-IgG.

Keywords

Aquaporin-4 antibody Neuromyelitis optica Optic neuritis Optical coherence tomography Visual function 

Notes

Acknowledgements

We would like to thank Dr Daisy J. Gonzales for reviewing this manuscript.

Conflicts of interest

N. Mekhasingharak, None; N. Chirapapaisan, None; P. Laowanapiban, None; S. Siritho, Speaker fees (Biogen Idec, Menarini, Merck Serono, Novartis, Pacific Healthcare, UCB), Travel fees (Biogen Idec, Menarini, Merck Serono, Novartis, Pacific Healthcare, UCB); N. Prayoonwiwat, Speaker fees (Bayer Schering Pharma, Eisai, Novartis, Pfizer Pharmaceutical, Sanofi-Aventis), Travel fees (Bayer Schering Pharma, Eisai, Novartis, Pfizer Pharmaceutical, Sanofi-Aventis); C. Satukijchai, Travel fees (Biogen Idec, Merck Serono, Novartis, UCB); J. Jitprapaikulsan, None; P. Mekhasingharak, None.

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Copyright information

© Japanese Ophthalmological Society 2018

Authors and Affiliations

  • Nattapong Mekhasingharak
    • 1
  • Niphon Chirapapaisan
    • 2
  • Poramaet Laowanapiban
    • 3
  • Sasitorn Siritho
    • 4
    • 5
  • Naraporn Prayoonwiwat
    • 4
  • Chanjira Satukijchai
    • 4
    • 6
  • Jiraporn Jitprapaikulsan
    • 4
  • Pornsawan Mekhasingharak
    • 4
  • Siriraj Neuroimmunology Research Group
  1. 1.Department of Ophthalmology, Naresuan University HospitalNaresuan UniversityPhitsanulokThailand
  2. 2.Department of Ophthalmology, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
  3. 3.Department of OphthalmologyMettapracharak HospitalNakhon PathomThailand
  4. 4.Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
  5. 5.Bumrungrad International HospitalBangkokThailand
  6. 6.Bangkok Hospital Headquarters, BDMSBangkokThailand

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