Abstract
Little work has been performed on the long-term outcome of optic neuritis (ON) according to the status of aquaporin-4 antibody (AQP4-Ab) and long-term prognosis in older patients in China. This study retrospectively analyzed medical records in a cohort of Chinese patients with 5-year follow-up according to AQP4-Ab status and ages from January 2009 to December 2010. The clinical features, laboratory findings and risk factors for prognosis were analyzed. A total of 128 ON patients were included, 66.4 % of whom were female. The median age at onset was 36.8 years (range 18–73). Serum AQP4-Ab was positive in 45 (35.2 %) patients, with greater frequency in the female, bilateral, and recurrent ON groups (48.2, 42.5 and 53.6 %, respectively). Seropositive AQP4-Ab ON patients had worse visual recovery compared to seronegative patients (p = 0.033). The average and four quadrants of retinal nerve fiber layer (RNFL) thickness were significantly thinner in the seropositive group than in the seronegative group (p < 0.05). At 5-year follow-up, the ON recurrence rate was higher in the seropositive AQP4-Ab patients (37/45, 82.3 %) than in the seronegative patients (35/83, 42.2 %, p < 0.001). Among the seropositive patients, 40 % (18/45) developed neuromyelitis optica (NMO). Only 1.2 % (1/83) of the seronegative patients developed NMO and 4.8 % (4/83) developed to MS. Further, the multivariate analysis in seropositive AQP4-Ab patients showed that two risk factors for transverse myelitis (TM) episode were ocular pain and recurrence within 1 year. The older patients had worse visual outcome after the first episode of ON than the younger patients (p = 0.007). However, the two groups did not differ significantly with regard to prevalence of AQP4-Ab, long-term visual recovery and the risk of developing to NMO/MS.
Similar content being viewed by others
References
Toosy AT, Mason DF, Miller DH (2014) Optic neuritis. Lancet Neurol 13:83–99
Wingerchuk DM, Banwell B, Bennett JL, Cabre P, Carroll W, Chitnis T et al (2015) International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology 85:177–189
Jarius S, Frederikson J, Waters P, Paul F, Akman-Demir G, Marignier R et al (2010) Frequency and prognostic impact of antibodies to aquaporin-4 in patients with optic neuritis. J Neurol Sci 298:158–162
Optic Neuritis Study G (2008) Visual function 15 years after optic neuritis: a final follow-up report from the Optic Neuritis Treatment Trial. Ophthalmology 115(1079–82):e5
Wakakura M, Minei-Higa R, Oono S, Matsui Y, Tabuchi A, Kani K et al (1999) Baseline features of idiopathic optic neuritis as determined by a multicenter treatment trial in Japan. Optic Neuritis Treatment Trial Multicenter Cooperative Research Group (ONMRG). Jpn J Ophthalmol 43:127–132
Petzold A, Pittock S, Lennon V, Maggiore C, Weinshenker BG, Plant GT (2010) Neuromyelitis optica-IgG (aquaporin-4) autoantibodies in immune mediated optic neuritis. J Neurol Neurosurg Psychiatry 81:109–111
Rizzo JF 3rd, Lessell S (1991) Optic neuritis and ischemic optic neuropathy: overlapping clinical profiles. Arch Ophthalmol 109:1668–1672
Rodriguez M, Siva A, Cross SA, O’Brien PC, Kurland LT (1995) Optic neuritis: a population-based study in Olmsted County, Minnesota. Neurology 45:244–250
Milo R, Miller A (2014) Revised diagnostic criteria of multiple sclerosis. Autoimmun Rev 13:518–524
Wingerchuk DM, Banwell B, Bennett JL, Cabre P, Carroll W, Chitnis T et al (2015) International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology 85:177–189
Tang Y, Wang X, Wang J, Huang W, Gao Y, Luo Y et al (2015) Prevalence and causes of visual impairment in a chinese adult population: the Taizhou Eye Study. Ophthalmology 122:1480–1488
Yang Y, Huang DH, Wu WP, Wu L, Chen LF, Wu Q (2013) The role of aquaporin-4 antibodies in Chinese patients with neuromyelitis optica. J Clin Neurosci Off J Neurosurg Soc Australas 20:94–98
Optic Neuritis Study G (2008) Multiple sclerosis risk after optic neuritis: final optic neuritis treatment trial follow-up. Arch Neurol 65:727–732
Matiello M, Lennon VA, Jacob A, Pittock SJ, Lucchinetti CF, Wingerchuk DM et al (2008) NMO-IgG predicts the outcome of recurrent optic neuritis. Neurology 70:2197–2200
Ambika S, Balasubramanian M, Theresa L, Veeraputhiran A, Arjundas D (2015) Aquaporin 4 antibody [NMO Ab] status in patients with severe optic neuritis in India. Int Ophthalmol 35:801–806
Takagi M, Tanaka K, Suzuki T, Miki A, Nishizawa M, Abe H (2009) Anti-aquaporin-4 antibody-positive optic neuritis. Acta Ophthalmol 87:562–566
Long Y, Qiu W, Hu X, Peng F, Lu Z, Wang Y et al (2012) Anti-aquaporin-4 antibody in Chinese patients with central nervous system inflammatory demyelinating disorders. Clin Neurol Neurosurg 114:1131–1134
Lai C, Tian G, Takahashi T, Liu W, Yang L, Zhang X (2011) Neuromyelitis optica antibodies in patients with severe optic neuritis in China. J Neuroophthalmol Off J North Am Neuroophthalmol Soc 31:16–19
Kitley J, Leite MI, Nakashima I, Waters P, McNeillis B, Brown R et al (2012) Prognostic factors and disease course in aquaporin-4 antibody-positive patients with neuromyelitis optica spectrum disorder from the United Kingdom and Japan. Brain J Neurol 135:1834–1849
Pittock SJ, Lucchinetti CF (2016) Neuromyelitis optica and the evolving spectrum of autoimmune aquaporin-4 channelopathies: a decade later. Ann NY Acad Sci 1366:20–39
Siuko M, Tienari PJ, Saastamoinen KP, Atula S, Miettinen A, Kivela T et al (2014) Neuromyelitis optica and aquaporin-4 (AQP4) autoantibodies in consecutive optic neuritis patients in Southern Finland. Acta Ophthalmol 92:387–391
Li H, Zhang Y, Yi Z, Huang D, Wei S (2014) Frequency of autoantibodies and connective tissue diseases in Chinese patients with optic neuritis. PLoS One 9:e99323
Pirko I, Blauwet LA, Lesnick TG, Weinshenker BG (2004) The natural history of recurrent optic neuritis. Arch Neurol 61:1401–1405
Peng JT, Cong HR, Yan R, Kong XY, Jiang HQ, Wei WB et al (2015) Neurological outcome and predictive factors of idiopathic optic neuritis in China. J Neurol Sci 349:94–98
Yamasaki K, Horiuchi I, Minohara M, Kawano Y, Ohyagi Y, Yamada T et al (1999) HLA-DPB1*0501-associated opticospinal multiple sclerosis: clinical, neuroimaging and immunogenetic studies. Brain J Neurol 122(Pt 9):1689–1696
Wang H, Dai Y, Qiu W, Zhong X, Wu A, Wang Y et al (2011) HLA-DPB1 0501 is associated with susceptibility to anti-aquaporin-4 antibodies positive neuromyelitis optica in southern Han Chinese. J Neuroimmunol 233:181–184
Wang W, Chen YP, Wei DN (2011) The clinical characteristics of early-onset versus late-onset types of myasthenia gravis. Zhonghua nei ke za zhi 50:496–498
Zivkovic SA, Clemens PR, Lacomis D (2012) Characteristics of late-onset myasthenia gravis. J Neurol 259:2167–2171
Titulaer MJ, McCracken L, Gabilondo I, Iizuka T, Kawachi I, Bataller L et al (2013) Late-onset anti-NMDA receptor encephalitis. Neurology 81:1058–1063
Choi J, Kim SJ, Chang JW, Kim JH, Yu YS (2012) Clinical characteristics of optic neuritis in Koreans greater than 50 years of age. Korean J Ophthalmol KJO 26:111–115
Reindl M, Di Pauli F, Rostasy K, Berger T (2013) The spectrum of MOG autoantibody-associated demyelinating diseases. Nat Rev Neurol 9:455–461
Ramanathan S, Reddel SW, Henderson A, Parratt JD, Barnett M, Gatt PN et al (2014) Antibodies to myelin oligodendrocyte glycoprotein in bilateral and recurrent optic neuritis. Neurology(R) Neuroimmunol Neuroinflamm 1:e40
Acknowledgments
This work is supported by the 863 Plan Biological and Medical Technology project “Development of equipment in diagnosis and visual function evaluation for optic neuritis”, China (NO: 2015AA020511).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
All the authors declare that there are no conflicts of interest.
Ethical standard
This study was approved by the People’s Liberation Army General Hospital Ethics Committee and was conducted following the Declaration of Helsinki in its currently applicable version. All individuals voluntarily participated in this study after a thorough oral and written information procedure. Oral and written consents were obtained from all participants.
Additional information
H. Zhou, S. Zhao and D. Yin were co-first authors and they contributed equally.
Rights and permissions
About this article
Cite this article
Zhou, H., Zhao, S., Yin, D. et al. Optic neuritis: a 5-year follow-up study of Chinese patients based on aquaporin-4 antibody status and ages. J Neurol 263, 1382–1389 (2016). https://doi.org/10.1007/s00415-016-8155-7
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00415-016-8155-7