Journal of Neurology

, Volume 263, Issue 5, pp 883–887 | Cite as

Plasma exchange response in 34 patients with severe optic neuritis

  • Romain Deschamps
  • Antoine Gueguen
  • Nathalie Parquet
  • Samir Saheb
  • Francoise Driss
  • Malcie Mesnil
  • Catherine Vignal
  • Jennifer Aboab
  • Raphael Depaz
  • Olivier Gout
Original Communication

Abstract

Optic neuritis could lead to severe visual impairment despite corticosteroids. Our aim was to evaluate the rate of visual improvement in patients treated with plasma exchange (PLEX) for severe steroid unresponsive optic neuritis and to identify predictive factors of outcome. Thirty-four patients (41 optic nerves damaged) with remaining visual acuity of 0.1 or less despite steroid pulse therapy were treated with PLEX from September 2010 to May 2015. Demographic and clinical neuro-ophthalmic findings, and spectral domain-optical coherence tomography data before PLEX treatment were analyzed. The mean symptom duration before PLEX was 34.6 days (median 28 days; range 6–92 days). After PLEX, the median final visual acuity was 0.8 and in 56 % of cases, final acuity was 0.5 or better. Past history of ipsilateral optic neuritis was associated significantly with poor outcome defined as final acuity less than 0.5. No significant difference in the visual outcome after PLEX was found between multiple sclerosis and neuromyelitis optica. In conclusion, this observational study showed that PLEX as second-line therapy led to a functionally important visual recovery in more than half patients with severe optic neuritis.

Keywords

Plasmapheresis Optic neuritis Corticosteroids Multiple sclerosis Neuromyelitis optica Myelin oligodendrocyte glycoprotein 

Notes

Compliance with ethical standards

Ethical standards

This study was approved by our institutional review board.

Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Romain Deschamps
    • 1
  • Antoine Gueguen
    • 1
  • Nathalie Parquet
    • 2
  • Samir Saheb
    • 3
  • Francoise Driss
    • 4
  • Malcie Mesnil
    • 5
  • Catherine Vignal
    • 6
  • Jennifer Aboab
    • 1
  • Raphael Depaz
    • 1
  • Olivier Gout
    • 1
  1. 1.Service de NeurologieFondation Ophtalmologique Adolphe de RothschildParisFrance
  2. 2.Unité d’hémaphérèse thérapeutiqueHôpital Saint-Louis, APHPParisFrance
  3. 3.Service d’hématologie clinique et de Thérapie CellulaireHôpital de la Pitié-Salpêtrière, AP-HPParisFrance
  4. 4.Unité de thérapeutique transfusionnelleHôpital universitaire Bicêtre, AP-HPLe Kremlin-BicêtreFrance
  5. 5.Département d’anesthésie réanimationFondation Ophtalmologique Adolphe de RothschildParisFrance
  6. 6.Service d’ophtalmologieFondation Ophtalmologique Adolphe de RothschildParisFrance

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