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Clinical features and visual prognosis of very late-onset neuromyelitis optica spectrum disorder–related optic neuritis

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Abstract

Background

Very late-onset neuromyelitis optica spectrum disorder–related optic neuritis is limited to a few case reports.

Objective

To investigate the clinical features and visual prognosis of very late-onset neuromyelitis optica spectrum disorder–related optic neuritis.

Methods

This study evaluated 22 patients with first-onset optic neuritis and fulfilled the 2015 diagnosis criteria for neuromyelitis optica spectrum disorders.

Results

The mean age at optic neuritis onset was 73.91 ± 4.71 (range: 70–82) years with a female predominance (81.8%; ratio: 4.5:1). Antinuclear antibody seropositivity and seronegativity were identified in 12 (55.5%) and 10 (45.5%) patients, respectively. Severe visual loss persisted in 19 (19/42, 45.3%) eyes at the last follow-up. Although patients with antinuclear antibody seropositivity had a significantly higher frequency of attacks (P = 0.015), but they had a longer median time to reach severe visual loss (37 vs. 26 months; log-rank test, P = 0.023). Multivariate logistic regression analysis revealed antinuclear antibody seropositivity (hazard ratio = 4.849, 95% confidence interval: 1.309–17.965, P = 0.018) as a good predictor of visual acuity improvement.

Conclusion

Patients with very late-onset neuromyelitis optica spectrum disorder–related optic neuritis may develop severe optic neuritis, and those with antinuclear antibody seronegativity have a similar clinical presentation but worse outcome than those with seropositivity.

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Acknowledgements

The authors thank the NMOSD patients at the Beijing Tongren Hospital for their participation and support.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Department of Neurology of Beijing Tongren Hospital, Capital Medical University, Beijing, China

    Qinglin Yang, Chuntao Lai, Chao Meng & Jiawei Wang

  2. Department of Radiology of Beijing Tongren Hospital, Capital Medical University, Beijing, China

    Qinglin Chang

  3. Department of Neurology of Xuanwu Hospital, Capital Medical University, Beijing, China

    Na Wei

Authors
  1. Qinglin Yang
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  2. Chuntao Lai
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  3. Chao Meng
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  4. Qinglin Chang
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  5. Na Wei
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  6. Jiawei Wang
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Correspondence to Qinglin Yang.

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Yang, Q., Lai, C., Meng, C. et al. Clinical features and visual prognosis of very late-onset neuromyelitis optica spectrum disorder–related optic neuritis. Neurol Sci 45, 2191–2197 (2024). https://doi.org/10.1007/s10072-023-07187-9

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  • DOI: https://doi.org/10.1007/s10072-023-07187-9

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