BACKGROUND Atypical optic neuritis,consisting of neuromyelitis optica spectrum disorders(NMOSD)or myelin oligodendrocyte glycoprotein antibody disease(MOGAD),has a very similar presentation but different prognostic im...BACKGROUND Atypical optic neuritis,consisting of neuromyelitis optica spectrum disorders(NMOSD)or myelin oligodendrocyte glycoprotein antibody disease(MOGAD),has a very similar presentation but different prognostic implications and longterm management strategies.Vascular and metabolic factors are being thought to play a role in such autoimmune neuro-inflammatory disorders,apart from the obvious immune mediated damage.With the advent of optical coherence tomography angiography(OCTA),it is easy to pick up on these subclinical macular microvascular and structural changes.AIM To study the macular microvascular and structural changes on OCTA in atypical optic neuritis.METHODS This observational cross-sectional study involved 8 NMOSD and 17 MOGAD patients,diagnosed serologically,as well as 10 healthy controls.Macular vascular density(MVD)and ganglion cell+inner plexiform layer thickness(GCIPL)were studied using OCTA.RESULTS There was a significant reduction in MVD in NMOSD and MOGAD affected as well as unaffected eyes when compared with healthy controls.NMOSD and MOGAD affected eyes had significant GCIPL thinning compared with healthy controls.NMOSD unaffected eyes did not show significant GCIPL thinning compared to healthy controls in contrast to MOGAD unaffected eyes.On comparing NMOSD with MOGAD,there was no significant difference in terms of MVD or GCIPL in the affected or unaffected eyes.CONCLUSION Although significant microvascular and structural changes are present on OCTA between atypical optic neuritis and normal patients,they could not help in differentiating between NMOSD and MOGAD cases.展开更多
BACKGROUND Collagenous sprue is a serious intestinal malabsorption disorder characterized by dull and flattened intestinal villi with subepithelial collagen deposition.At present,fewer than 100 cases have been reporte...BACKGROUND Collagenous sprue is a serious intestinal malabsorption disorder characterized by dull and flattened intestinal villi with subepithelial collagen deposition.At present,fewer than 100 cases have been reported in the literature.Owing to the rarity of this disease,clinicians and pathologists have insufficient understanding of it.CASE SUMMARY The authors present a case of a 34-year-old female patient who presented with severe watery diarrhea with significant weight loss.She also experienced blurred binocular vision.The intestinal lesions were located mainly in the small intestine,which presented flat and dull intestinal villi with subepithelial collagen deposition.Masson staining was positive.Glucocorticoids were effective for this patient,but there seemed to be glucocorticoid dependence.CONCLUSION Collagenous stomatitis diarrhea is a rare intestinal malabsorption disease that needs to be diagnosed in combination with special clinical manifestations and unique histological features.展开更多
AIM:To determine the diagnostic ability of various visual functions in patients with multiple sclerosis(MS)with and without optic neuritis(ON).METHODS:In this cross-sectional study,we assessed and compared refractive ...AIM:To determine the diagnostic ability of various visual functions in patients with multiple sclerosis(MS)with and without optic neuritis(ON).METHODS:In this cross-sectional study,we assessed and compared refractive error,visual acuity(VA),and contrast sensitivity(CS)between patients with MS and a matched control group of healthy individuals.The MS patients were further categorized into those with ON and those without.RESULTS:A total of 133 eyes from 133 participants were assessed,including 66 individuals diagnosed with MS.The mean ages for the MS group and the healthy control group were 37.5±4.27y and 38.45±4.60y,respectively(P=0.346).Among the 66 patients with MS,18 had ON.The presence of MS was associated with a decrease in best-corrected visual acuity(BCVA)and spherical component of refractive error(P<0.05),whereas ON did not lead to any further decline in these parameters(P>0.05).MS was linked to decreased CS at spatial frequencies of 6 and 18 cycles per degree(CPD;P<0.05),while ON in MS patients resulted in an additional decrease in CS at 3 CPD(P=0.03).The most significant sensitivity for distinguishing MS patients from healthy individuals as well as MS patients with ON from those without ON was found with cylindrical component[associated criterion(AC)>-0.75 D;71.21%]and CS at spatial frequency of 6 CPD(AC≤1.56;72.22%),respectively.Conversely,the highest specificity for these diagnostic measures was associated with BCVA(AC>0 logMAR;97.01%)and CS at a spatial frequency of 12 CPD(AC≤0.60;93.75%),respectively.CONCLUSION:MS significantly affects refractive error and CS,with ON further reducing CS.Assessing these visual parameters can improve MS monitoring and management.展开更多
Optic neuritis(ON)is a focal inflammatory demyelinating disorder of the optic nerve.Although classically regarded as a sentinel event for multiple sclerosis(MS),ON also occurs in antibody-mediated entities such as aqu...Optic neuritis(ON)is a focal inflammatory demyelinating disorder of the optic nerve.Although classically regarded as a sentinel event for multiple sclerosis(MS),ON also occurs in antibody-mediated entities such as aquaporin-4-IgGpositive neuromyelitis optica spectrum disorder(AQP4-NMOSD)and myelinoligodendrocyte-glycoprotein-antibody disease.In all these settings biological sex is a pivotal determinant of susceptibility,clinical expression,treatment response and long-term outcome.Data synthesized from an extensive literature analysis utilizing PubMed,Scopus,and Web of Science in this review shows that women experience ON far more frequently–with female-to-male ratios ranging from 3:1 in MS to almost 9:1 in AQP4-NMOSD–yet men,when affected,tend to accumulate irreversible neuro-axonal loss more rapidly.Sex-specific patterns arise at every biological stratum:X-linked gene dosage,epigenetic regulation,hormonal cycles from puberty through menopause,metabolic co-modifiers such as obesity and vitamin-D status,and psychosocial forces that influence healthcare utilization.By weaving these elements into an expanded narrative,the present review provides a detailed resource for clinicians and investigators aiming at gender-tailored management of ON.展开更多
Dear Editor,Myelin oligodendrocyte glycoprotein(MOG)is a minor component of myelin,expressed on the external surface of oligodendrocytes in the central nervous system(CNS)[1].Anti-MOG antibodies(MOG-ab)have been impli...Dear Editor,Myelin oligodendrocyte glycoprotein(MOG)is a minor component of myelin,expressed on the external surface of oligodendrocytes in the central nervous system(CNS)[1].Anti-MOG antibodies(MOG-ab)have been implicated in the demyelinating process and are considered unique biomarkers for a group of heterogeneous autoimmune inflammatory CNS diseases known as MOG-associated disorder(MOGAD)[1].MOGAD can present with a range of clinical manifestations,including optic neuritis,transverse myelitis,acute disseminating encephalomyelitis,and brainstem or cerebral encephalitis[1].Optic neuritis is the most common clinical feature of MOGAD in adults,typically manifesting as steroid-sensitive,recurrent,bilateral optic neuritis with optic disc swelling[1].展开更多
AIM:To assess the alterations in the resting-state function connections between the two cerebral hemispheres in patients with optic neuritis(ON)and healthy controls(HCs).METHODS:A total of 12 ON patients(six males and...AIM:To assess the alterations in the resting-state function connections between the two cerebral hemispheres in patients with optic neuritis(ON)and healthy controls(HCs).METHODS:A total of 12 ON patients(six males and six females)and 12 HCs(six males and six females)who were highly matched for sex,age,and educational level were recruited.They underwent functional magnetic resonance imaging(fMRI),testing and brain activities were assessed using the degree centrality(DC)method.Correlation analysis between the mean DC values in specific brain areas and behavior performances was analyzed as well.Linear correlations between A anxiety scale(AS)and depression scale(DS)values and DC values in brain regions of patients with ON were also analyzed.RESULTS:The areas that showed a higher DC value in ON patients were the right angular gyrus and bilateral precuneus,while the left insula and left superior temporal gyrus(LSTG)were regions that presented a lower DC value in ON patients.A receiver operating characteristic(ROC)curve analysis confirmed the accuracy of the area under the curve(AUC)assessment.Linear analysis showed anxiety scale(AS)and depression scale(DS)values in the left insula were both negatively correlated with DC values,while best corrected visual acuity logMAR-R(BCVA logMAR-R)showed a negative correlation with DC in the LSTG.CONCLUSION:The study explores altered brain activities of specific regions in patients with ON.The results provide clues for revealing the underlying mechanism of ON development.展开更多
AIM:To compare the macular structure including foveal thickness among patients with optic neuritis(ON)according to the etiology and to investigate the possible correlation between structural and visual outcomes METHOD...AIM:To compare the macular structure including foveal thickness among patients with optic neuritis(ON)according to the etiology and to investigate the possible correlation between structural and visual outcomes METHODS:In this retrospective cross-sectional study,the clinical data of patients with aquaporin-4 immunoglobulin G-related ON(AQP4 group,40 eyes),myelin oligodendrocyte glycoprotein IgG-related ON(MOG group,31 eyes),and multiple sclerosis-related ON(MS group,24 eyes)were obtained.The retinal thickness of the foveal,parafoveal and perifoveal regions were measured.Visual acuity(VA),visual field index and mean deviation were measured as visual outcomes.RESULTS:The AQP4 group showed a significantly thinner fovea(226.4±13.4μm)relative to the MOG(236.8±14.0μm,P=0.015)and MS(238.9±14.3μm,P=0.007)groups.The thickness in the parafoveal area also was thinner in the AQP4 group,though the difference in perifoveal retinal thickness was not significant.Foveal thickness was correlated with VA in the AQP4 group(coefficientρ=-0.418,P=0.014),but not in the MOG and MS groups(P=0.218 and P=0.138,respectively).There was no significant correlation between foveal thickness and visual field test in all three groups.CONCLUSION:The significant thinning in the fovea and parafoveal areas in the AQP4 group compared to the MOG and MS groups are found.Additionally,macular changes in AQP4-ON show a significant correlation with VA.The results provide the possibility that retinal structural damage could reflect functional damage in AQP4-ON,distinct from MOGON and MS-ON.展开更多
Objective:To evaluate the plasma levels of the otoconial proteins,otoconin-90 and otolin-1,in individuals diagnosed with vestibular neuritis(VN)and determine the feasibility of using these proteins as biomarkers for V...Objective:To evaluate the plasma levels of the otoconial proteins,otoconin-90 and otolin-1,in individuals diagnosed with vestibular neuritis(VN)and determine the feasibility of using these proteins as biomarkers for VN.Methods:In this preliminary study,30 patients diagnosed with VN and 70 healthy individuals were recruited and followed to confirm whether they had benign paroxysmal positional vertigo(BPPV)during the following time.The recorded data included measurements of height,weight,and history of diabetes mellitus or hypertension.Additionally,levels of plasma otoconin-90,and otolin-1 were measured and compared.Results:The plasma concentrations of otoconin-90 and otolin-1 may not be significantly different between patients with VN and healthy controls,nor among patients with BPPV secondary to VN and patients with VN without BPPV.Conclusions:Plasma otoconin-90 and otolin-1 levels may not serve as biomarkers of acute VN episodes or predict BPPV occurrence secondary to VN.展开更多
BACKGROUND A subtype of the Omicron variant of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is suggested to be responsible for the outbreak in Northern China since the quarantine was lifted in December 2...BACKGROUND A subtype of the Omicron variant of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is suggested to be responsible for the outbreak in Northern China since the quarantine was lifted in December 2022.The coronavirus disease 2019 virus is primarily responsible for the development of respiratory illnesses,however,it can present a plethora of symptoms affecting a myriad of body organs.This virus has been theorized to be linked to demyelinating lesions of the peripheral and central nervous system including transverse myelitis and acute retrobulbar optic neuritis(ARON).For example,magnetic resonance imaging(MRI)of the orbit and brain showed enlargement of the retrobulbar intraorbital segments of the optic nerve with high T2 signal,and no abnormalities were seen in the brain tissue.In this case series,we analyzed the connection between SARSCoV-2 infection and the onset of ARON.CASE SUMMARY Fifteen patients,and a teenage boy who did not have any pre-existing ocular or demyelinating diseases suddenly experienced a loss of vision after SARS-CoV-2 infection.The patients expressed a central scotoma and a fever as the primary concern.The results of the fundus photography were found to be normal.However,the automated perimetry and MRI scans showed evidence of some typical signs.Out of the 15 patients diagnosed with ARON after SARS-CoV-2 infection,only one individual tested positive for the aquaporin-4 antibody.CONCLUSION Direct viral invasion of the central nervous system and an immune-related process are the two primary causes of SARS-CoV-2-related ARON.展开更多
Optic neuritis (ON) is a kind of inflammatory disease characterized by optic nerve damage, which can lead to vision loss or even blindness. With the development of ON pathology, the medical community has gained a more...Optic neuritis (ON) is a kind of inflammatory disease characterized by optic nerve damage, which can lead to vision loss or even blindness. With the development of ON pathology, the medical community has gained a more comprehensive understanding of its immune-mediated complex processes. In addition, the treatment method has also developed from a single hormone therapy to a variety of treatment strategies including immunosuppressants, plasma exchange, immunoadsorption, etc., and the emerging therapy of stem cell transplantation has become the focus of attention. This review aims to explore the latest pathomechanisms of optic neuritis, comprehensively analyze the current therapeutic research advances, and provide a reference for future therapeutic directions.展开更多
Objective To observe the clinical effects of centro-square needling combined with ginger moxibustion on neuritis of lateral cutaneous nerve of thigh. Methods Centro-square needling combined with ginger moxibustion was...Objective To observe the clinical effects of centro-square needling combined with ginger moxibustion on neuritis of lateral cutaneous nerve of thigh. Methods Centro-square needling combined with ginger moxibustion was used in all the thirty-five cases. Ashi points, Xuèhǎi （血海 SP 10）, Zúsānlǐ （足三里 ST 36）, Yīnlíngquán （阴陵泉 SP 9） and Sānyīnjīao （三阴交 SP 6） on affected side were chosen. The treatment frequency was once a day, and a course was 2 weeks. The clinical effects were observed after 2 courses. Results 23 cases got cure, 7 cases were marked effective, 3 cases were effective and 2 were failed in all the 35 cases. The total effective rate was 94.3% （33/35）. Conclusion The centro-square needling combined with ginger moxibustion has obvious effect on neuritis of lateral cutaneous nerve of thigh.展开更多
Objective To evaluate the optic nerve impairment using MRI histogram texture analysis in the patients with optic neuritis.Methods The study included 60 patients with optic neuritis and 20 normal controls. The coronal ...Objective To evaluate the optic nerve impairment using MRI histogram texture analysis in the patients with optic neuritis.Methods The study included 60 patients with optic neuritis and 20 normal controls. The coronal T2 weighted imaging(T2 WI) with fat saturation and enhanced T1 weighted imaging(T1 WI) were performed to evaluate the optic nerve. MRI histogram texture features of the involved optic nerve were measured on the corresponding coronal T2 WI images. The normal optic nerve(NON) was measured in the posterior 1/3 parts of the optic nerve. Kruskal-Wallis one-way ANOVA was used to compare the difference of texture features and receiver operating characteristic(ROC) curve were performed to evaluate the diagnostic value of texture features for the optic nerve impairment among the affected optic nerve with enhancement(ONwEN), affected optic nerve without enhancement(ONwoEN), contralateral normal appearing optic nerve(NAON) and NON. Results The histogram texture Energy and Entropy presented significant differences for ONwEN vs. ONwoEN(both P = 0.000), ONwEN vs. NON(both P = 0.000) and NAON vs. NON(both P < 0.05). ROC analysis demonstrated that the area under the curve(AUC) of histogram texture Energy were 0.758, 0.795 and 0.701 for ONwEN vs. ONwoEN, ONwEN vs. NON and NAON vs. NON, AUC of Entropy were 0.758, 0.795 and 0.707 for ONwEN vs. ONwoEN, ONwEN vs. NON and NAON vs. NON.Conclusion The altered MRI histogram texture Energy and Entropy could be considered as a surrogate for MRI enhancement to evaluate the involved optic nerve and normal-appearing optic nerve in optic neuritis.展开更多
A 27 year-old lady,presented with sudden loss of vision in the right eve tor a week.It was followed In poor vision in the left eye alter 3 days.It involved the whole entire visual field and was associated with pain on...A 27 year-old lady,presented with sudden loss of vision in the right eve tor a week.It was followed In poor vision in the left eye alter 3 days.It involved the whole entire visual field and was associated with pain on eye movement.She was diagnosed to have miliary tuberculosis and retroviral disease 4 months ago.She was started on anti-TB since then but defaulted highly active anti-retroviral therapy(HAART).On examination.her visual acuity was no perception of light in the right eye and 6/120(pinhole 3/60) in the lelt eye.Anterior segment in both eyes was unremarkable.Funduscopy showed bilateral optic disc swelling with presence ot multiple foci of choroiditis in the peripheral retina.The vitreous and relinal vessels were normal.Chest radiography was normal.CT scan of orbit and brain revealed bilateral enhancement of the optic nerve sheath that suggest the diagnosis of bilateral atypical optic neuritis.This patient was managed with infectious disease team.She was started on HAART and anti-TB treatment was continued.She completed anti-TB treatment alter 9 months without any serious side effects.During follow up the visual acuity in both eyes was not improved.However.funduscopy showed resolving ol disc swelling and choroiditis following treatment.展开更多
AIM：To determine whether gypenosides have protective effects in experimental autoimmune optic neuritis（EAON）.METHODS：Mice were randomly divided into seven groups：control group,model group,three different density ...AIM：To determine whether gypenosides have protective effects in experimental autoimmune optic neuritis（EAON）.METHODS：Mice were randomly divided into seven groups：control group,model group,three different density gypenosides monotherapy,methylprednisolone monotherapy,combination of gypenosides and methylprednisolone group.The control group was subcutaneously injected with oil emulsion adjuvant and all other groups were subcutaneously immunized with an emulsified mixture of myelin oligodendrocyte glycoprotein（MOG） 35-55 peptide to induce EAON.Mice in the gypenosides groups were administered injections daily with three concentrations（15 mg/kg,30 mg/kg,45 mg/kg） of gypenosides respectively.Mice in the methylprednisolone group and the combination treatment group were injected daily with methylprednisolone（20 mg/kg） or methylprednisolone（20 mg/kg） ＋ gypenosides（30 mg/kg）,respectively.After MOG immunization,visual evoked potential（VEP）,optical coherence tomography（OCT）,and histopathologic examination were performed at 14,20,30,and 40 d post-inoculation（p.i.）.All results were expressed as mean±SEM.The data were evaluated by oneway ANOVA followed by Tukey or Games-Howell test.RESULTS：Compared with the control group,p2 latency was prolonged in the model group（P=0.041）.Combination treatment can alleviated the change in VEP at 20 d p.i.（P=0.012）.Average peripapillary retinal nerve fiber layer（RNFL） thickness was reduced in the model group（P= 0.000,30d;P=0.000,40d） and gypenosides treatment remarkably diminished the degree of RNFL degenerationat 30 d and 40 d p.i（P=0.000,30d;P=0.000,40d）.The pathomorphological results showed a decrease in demyelination（P=0.020） and inflammatory reactions in the combination group compared with the model group（20d p.i.）.Gypenosides treatment also alleviated the degree of axonal loss（40d p.i.）（P=0.003）.CONCLUSION：Treatment with gypenosides exerts protective effects on retinal nerve fibers and axons in EAON.When combined with gypenosides,methylprednisolone reduces demyelination in the acute stage of EAON.展开更多
The diagnosis of the recurrent optic neuritis is commonly established clinically,and sometimes it could be challenging because the involved optic nerve does not always show significant enhancement on conventional cont...The diagnosis of the recurrent optic neuritis is commonly established clinically,and sometimes it could be challenging because the involved optic nerve does not always show significant enhancement on conventional contrast enhanced-T1 weighted imaging（CE-T1W1）.In this paper,we reported a middle-aged female with early diagnosis of recurrent optic neuritis using contrast-enhanced T2 fluid-attenuated inversion recovery imaging（CET2FLAIR）.The involved optic nerve presented evident enhancement on CE-T2FLAIR and no enhancement on CE-T1W1.This case suggested that the CE-T2FLAIR may be a useful diagnostic tool specifically for the recurrent optic neuritis in clinical practice.展开更多
AIM：To compare the thickness of the peripapillary retinal nerve fiber layer（RNFL）and ganglion cell-inner plexiform layer（GCIPL）among patients with various forms of optic neuritis（ON）and to identify whether any ...AIM：To compare the thickness of the peripapillary retinal nerve fiber layer（RNFL）and ganglion cell-inner plexiform layer（GCIPL）among patients with various forms of optic neuritis（ON）and to identify whether any particular parameters or their thinning pattern can be used to distinguish the type of ON.METHODS：This prospective study was conducted at the Department of Ophthalmology,Faculty of Medicine,Siriraj Hospital,Thailand,between January,2015 and December,2016.We enlisted patients over 18 years of age with history of ON and categorized patients into 4 groups：1）aquaporin 4 antibodies（AQP4-IgG）positive;2）multiple sclerosis（MS）;3）myelin oligodendrocyte glycoprotein antibodies（MOG-IgG）positive;4）idiopathic-ON patients.Healthy controls were also included during the same study period.All patients underwent complete ophthalmological examination and spectral domain optical coherence tomography（OCT）imaging to analyze RNFL and GCIPL thickness after at least 3mo since the last episode of acute ON.The generalized estimating equation（GEE）models were used to compare the data amongst ON groups. RESULTS： Among 87 previous ON eyes from 57 patients（43 AQP4-IgG＋ON,17 MS-ON,8 MOG-IgG＋ON,and 19idiopathic-ON）,mean logMAR visual acuity of AQP4-IgG＋ON,MS-ON,MOG-IgG＋ON,and idiopathic-ON groups was 0.76±0.88,0.12±0.25,0.39±0.31,and 0.75±1.08,respectively.Average,superior,and inferior RNFL were significantly reduced in AQP4-IgG＋ON,MOG-IgG＋ON and idiopathic-ON eyes,relative to those of MS-ON.Differences were not statistically significant for RNFL or GCIPL between the AQP4-IgG＋ON and MOG-IgG＋ON groups,whereas visual acuity in MOG-IgG＋ON was slightly,but not significantly,better（0.39 vs 0.76）.Although RNFL thickness in MOG-IgG＋ON was significantly reduced as compared to MS-ON,mean visual acuity and GCIPL were not different.CONCLUSION：Thinning of superior and inferior quadrants of RNFL are more commonly seen in MOG-IgG＋ON and AQP4-IgG＋ON.Long term visual acuity in MOG-IgG＋ON is often better than AQP4-IgG＋ON,whereas the structural change from OCT is comparable.展开更多
AIM:To determine the clinical features,diagnosis and treatment of the primary Sjogren syndrome(SS)related optic neuritis.METHODS:The clinical data of 8 patients(12 eyes)with primary SS related optic neuritis were anal...AIM:To determine the clinical features,diagnosis and treatment of the primary Sjogren syndrome(SS)related optic neuritis.METHODS:The clinical data of 8 patients(12 eyes)with primary SS related optic neuritis were analyzed retrospectively.RESULTS:Eight of 128 consecutive patients with optic neuritis resulted from varied causes fulfilled the diagnostic criteria for the primary SS.They presented initially with the signs and symptoms of non-specific optic neuritis,and 5 patients presenting without dryness showed a chronic inflammation of submandibular gland or parotid gland,and lymphocyte infiltration was demonstrated by labial gland biopsy in 2 patients.There were serum positive titers for anti-Sjogren syndrome A(SSA)in 7 patients and anti-Sjogren syndrome B(SSB)in 8 patients.Anti-aquaporin-4(AQP4)antibody was negative in all the 8 patients.Both glucocorticoids and immunosuppressive agent were administered,and visual acuity elevated in 8 eyes(66.7%),3 patients(37.5%)recurred in the follow-up.CONCLUSION:Primary SS related optic neuritis is less common and easily misdiagnosed.The conventional therapies for optic neuritis could not control the recurrence.展开更多
AIM: To assess the relationships of final best-corrected visual acuity(BCVA) and the optic nerve structural loss in varying age-cohorts of optic neuritis(ON) patients.METHODS: This is a retrospective, cross-sectional ...AIM: To assess the relationships of final best-corrected visual acuity(BCVA) and the optic nerve structural loss in varying age-cohorts of optic neuritis(ON) patients.METHODS: This is a retrospective, cross-sectional study.Totally 130 ON subjects(200 eyes) without ON onset within 6mo were included, who underwent BCVA assessment,peripapillary retinal nerve fibre layer(pRNFL) and macular segmented layers evaluation by optical coherence tomography(OCT).RESULTS: For the 0-18y cohort, the final BCVA(logMAR)was significantly better and less frequent recurrences than adult cohorts(P=0.000). The final BCVA(logMAR) in all age-cohorts of the ON patients had negative and linear correlations to the pRNFL thicknesses and macular retinal ganglion cell layer(mRGCL) volumes, when the pRNFL thicknesses were reduced to the thresholds of 57.2-67.5 μm or 0.691-0.737 mm;in mRGCL volumes, respectively, with the strongest interdependence in the 19-40y cohort. The ON patients from varying age cohorts would be threatened by blindness when their pRNFL thicknesses dropped 36.7-48.3 μm or the mRGCL volumes dropped to 0.495-0.613 mm;.CONCLUSION: The paediatric ON has best prognosis and young adult ON exhibits perfectly linear correlations of final vision and structural loss. The pRNFL and the mRGCL could be potential structural markers to predict the vision prognosis for varying-age ON patients.展开更多
AIM:To elucidate the changes of different ganglion cell layer(GCL)thinning patterns between the optic neuritis(ON)and non-arteritic anterior ischemic optic neuropathy(NAION).METHODS:A prospective,observational study w...AIM:To elucidate the changes of different ganglion cell layer(GCL)thinning patterns between the optic neuritis(ON)and non-arteritic anterior ischemic optic neuropathy(NAION).METHODS:A prospective,observational study was conducted to evaluate the timing of GCL changes between acute ON and NAION using optical coherence tomography.RESULTS:Thinning on optical coherence tomography in the NAION group occurs as early as 11 d after symptomatic onset of vision loss and follows an altitudinal pattern.The mean superior-inferior GCL thickness difference in the NAION cohort was clinically significant at 5.7μm in the NAION cohort compared to controls of 0.8μm(P=0.032),but not significant in the ON group compared to controls with both groups measuring 1.1μm.Global thinning was significant for the ON group compared to controls at 7.2μm(P=0.011)but not the NAION group compared to controls at 1.35μm.CONCLUSION:These findings suggest that future treatments for NAION should be given early,and possibly before 11 d in order to prevent GCL and irreversible vision loss.展开更多
BACKGROUND： Minocycline, a tetracycline derivative, is neuroprotective in models of various neurological diseases. OBJECTIVE： To investigate the effects of minocycline on retinal ganglion cells （RGCs） in rats with...BACKGROUND： Minocycline, a tetracycline derivative, is neuroprotective in models of various neurological diseases. OBJECTIVE： To investigate the effects of minocycline on retinal ganglion cells （RGCs） in rats with optic neuritis, and to compare with the effects of methylprednisolone. DESIGN, TIME AND SETTING： This neuropathology controlled study was performed at the First Affiliated Hospital, Chongqing Medical University, China in May 2007. MATERIALS： A total of 22 female Wistar rats were randomly assigned into a normal control group （n ： 5） and an experimental group （n = 17）. The experimental group was composed of a model subgroup （n = 7）, a minocycline subgroup （n = 5）, and a methylprednisolone subgroup （n = 5）. Minocycline was supplied by Sigma, USA. METHODS： Antigen homogenate made from guinea pig spinal cord and complete Freund adjuvant was used to induce autoimmune encephalomyelitis, which could induce demyelinated optic neuritis models. Rats in the minocycline subgroup were intraperitoneally injected with minocycline （45 mg/kg） daily from day 8 following autoimmunity. Rats in the methylprednisolone subgroup were intraperitoneally injected with methylprednisolone （20 mg/kg） daily from day 8 following autoimmunity. MAIN OUTCOME MEASURES： On day 18 after autoimmunily induction, pathological changes in the optic nerve were observed by hematoxylin-eosin staining. The percentage area of axons in the transverse section of the optic nerve was measured by Bielschowsky staining. Apoptosis of RGCs was detected by TUNEL. RESULTS： Under an optical microscope, the optic nerve in rats with demyelinated optic neuritis showed a vacuole-like structure of fibers, irregular swelling of the axons, and infiltration of a large quantity of inflammatory cells. With an electron microscope, the optic nerve presented with vacuole-like structures in the axons, a small percentage area of axons in the transverse section, loose myelin sheaths, and microtubules and microfilaments disappeared. The pathological changes in the optic nerve met the changes in demyelinated optic neuritis. Moreover, there was significant apoptosis of RGCs. The percentage area of optic nerve axons in the transverse section was significantly increased and the number of apoptotic RGCs was increased after treatment with methylprednisolone and minocycline. Compared with methylprednisolone, minocycline had better effects on reducing RGC apoptosis （P 〈 0.05）. CONCLUSION： Minocycline has better inhibitory effects on RGC apoptosis than methylprednisolone. Minocycline can decrease the damage to axons of demyelinated optic neuritis rats, and has similar protective effects on neurons from demyelinated optic neuritis rats as methylprednisolone.展开更多
文摘BACKGROUND Atypical optic neuritis,consisting of neuromyelitis optica spectrum disorders(NMOSD)or myelin oligodendrocyte glycoprotein antibody disease(MOGAD),has a very similar presentation but different prognostic implications and longterm management strategies.Vascular and metabolic factors are being thought to play a role in such autoimmune neuro-inflammatory disorders,apart from the obvious immune mediated damage.With the advent of optical coherence tomography angiography(OCTA),it is easy to pick up on these subclinical macular microvascular and structural changes.AIM To study the macular microvascular and structural changes on OCTA in atypical optic neuritis.METHODS This observational cross-sectional study involved 8 NMOSD and 17 MOGAD patients,diagnosed serologically,as well as 10 healthy controls.Macular vascular density(MVD)and ganglion cell+inner plexiform layer thickness(GCIPL)were studied using OCTA.RESULTS There was a significant reduction in MVD in NMOSD and MOGAD affected as well as unaffected eyes when compared with healthy controls.NMOSD and MOGAD affected eyes had significant GCIPL thinning compared with healthy controls.NMOSD unaffected eyes did not show significant GCIPL thinning compared to healthy controls in contrast to MOGAD unaffected eyes.On comparing NMOSD with MOGAD,there was no significant difference in terms of MVD or GCIPL in the affected or unaffected eyes.CONCLUSION Although significant microvascular and structural changes are present on OCTA between atypical optic neuritis and normal patients,they could not help in differentiating between NMOSD and MOGAD cases.
文摘BACKGROUND Collagenous sprue is a serious intestinal malabsorption disorder characterized by dull and flattened intestinal villi with subepithelial collagen deposition.At present,fewer than 100 cases have been reported in the literature.Owing to the rarity of this disease,clinicians and pathologists have insufficient understanding of it.CASE SUMMARY The authors present a case of a 34-year-old female patient who presented with severe watery diarrhea with significant weight loss.She also experienced blurred binocular vision.The intestinal lesions were located mainly in the small intestine,which presented flat and dull intestinal villi with subepithelial collagen deposition.Masson staining was positive.Glucocorticoids were effective for this patient,but there seemed to be glucocorticoid dependence.CONCLUSION Collagenous stomatitis diarrhea is a rare intestinal malabsorption disease that needs to be diagnosed in combination with special clinical manifestations and unique histological features.
文摘AIM:To determine the diagnostic ability of various visual functions in patients with multiple sclerosis(MS)with and without optic neuritis(ON).METHODS:In this cross-sectional study,we assessed and compared refractive error,visual acuity(VA),and contrast sensitivity(CS)between patients with MS and a matched control group of healthy individuals.The MS patients were further categorized into those with ON and those without.RESULTS:A total of 133 eyes from 133 participants were assessed,including 66 individuals diagnosed with MS.The mean ages for the MS group and the healthy control group were 37.5±4.27y and 38.45±4.60y,respectively(P=0.346).Among the 66 patients with MS,18 had ON.The presence of MS was associated with a decrease in best-corrected visual acuity(BCVA)and spherical component of refractive error(P<0.05),whereas ON did not lead to any further decline in these parameters(P>0.05).MS was linked to decreased CS at spatial frequencies of 6 and 18 cycles per degree(CPD;P<0.05),while ON in MS patients resulted in an additional decrease in CS at 3 CPD(P=0.03).The most significant sensitivity for distinguishing MS patients from healthy individuals as well as MS patients with ON from those without ON was found with cylindrical component[associated criterion(AC)>-0.75 D;71.21%]and CS at spatial frequency of 6 CPD(AC≤1.56;72.22%),respectively.Conversely,the highest specificity for these diagnostic measures was associated with BCVA(AC>0 logMAR;97.01%)and CS at a spatial frequency of 12 CPD(AC≤0.60;93.75%),respectively.CONCLUSION:MS significantly affects refractive error and CS,with ON further reducing CS.Assessing these visual parameters can improve MS monitoring and management.
文摘Optic neuritis(ON)is a focal inflammatory demyelinating disorder of the optic nerve.Although classically regarded as a sentinel event for multiple sclerosis(MS),ON also occurs in antibody-mediated entities such as aquaporin-4-IgGpositive neuromyelitis optica spectrum disorder(AQP4-NMOSD)and myelinoligodendrocyte-glycoprotein-antibody disease.In all these settings biological sex is a pivotal determinant of susceptibility,clinical expression,treatment response and long-term outcome.Data synthesized from an extensive literature analysis utilizing PubMed,Scopus,and Web of Science in this review shows that women experience ON far more frequently–with female-to-male ratios ranging from 3:1 in MS to almost 9:1 in AQP4-NMOSD–yet men,when affected,tend to accumulate irreversible neuro-axonal loss more rapidly.Sex-specific patterns arise at every biological stratum:X-linked gene dosage,epigenetic regulation,hormonal cycles from puberty through menopause,metabolic co-modifiers such as obesity and vitamin-D status,and psychosocial forces that influence healthcare utilization.By weaving these elements into an expanded narrative,the present review provides a detailed resource for clinicians and investigators aiming at gender-tailored management of ON.
文摘Dear Editor,Myelin oligodendrocyte glycoprotein(MOG)is a minor component of myelin,expressed on the external surface of oligodendrocytes in the central nervous system(CNS)[1].Anti-MOG antibodies(MOG-ab)have been implicated in the demyelinating process and are considered unique biomarkers for a group of heterogeneous autoimmune inflammatory CNS diseases known as MOG-associated disorder(MOGAD)[1].MOGAD can present with a range of clinical manifestations,including optic neuritis,transverse myelitis,acute disseminating encephalomyelitis,and brainstem or cerebral encephalitis[1].Optic neuritis is the most common clinical feature of MOGAD in adults,typically manifesting as steroid-sensitive,recurrent,bilateral optic neuritis with optic disc swelling[1].
基金Supported by National Natural Science Foundation of China(No.82160195No.82460203)Key R&D Program of Jiangxi Province(No.20223BBH80014).
文摘AIM:To assess the alterations in the resting-state function connections between the two cerebral hemispheres in patients with optic neuritis(ON)and healthy controls(HCs).METHODS:A total of 12 ON patients(six males and six females)and 12 HCs(six males and six females)who were highly matched for sex,age,and educational level were recruited.They underwent functional magnetic resonance imaging(fMRI),testing and brain activities were assessed using the degree centrality(DC)method.Correlation analysis between the mean DC values in specific brain areas and behavior performances was analyzed as well.Linear correlations between A anxiety scale(AS)and depression scale(DS)values and DC values in brain regions of patients with ON were also analyzed.RESULTS:The areas that showed a higher DC value in ON patients were the right angular gyrus and bilateral precuneus,while the left insula and left superior temporal gyrus(LSTG)were regions that presented a lower DC value in ON patients.A receiver operating characteristic(ROC)curve analysis confirmed the accuracy of the area under the curve(AUC)assessment.Linear analysis showed anxiety scale(AS)and depression scale(DS)values in the left insula were both negatively correlated with DC values,while best corrected visual acuity logMAR-R(BCVA logMAR-R)showed a negative correlation with DC in the LSTG.CONCLUSION:The study explores altered brain activities of specific regions in patients with ON.The results provide clues for revealing the underlying mechanism of ON development.
基金Supported by the New Faculty Startup Fund of Seoul National University(Jung JH).
文摘AIM:To compare the macular structure including foveal thickness among patients with optic neuritis(ON)according to the etiology and to investigate the possible correlation between structural and visual outcomes METHODS:In this retrospective cross-sectional study,the clinical data of patients with aquaporin-4 immunoglobulin G-related ON(AQP4 group,40 eyes),myelin oligodendrocyte glycoprotein IgG-related ON(MOG group,31 eyes),and multiple sclerosis-related ON(MS group,24 eyes)were obtained.The retinal thickness of the foveal,parafoveal and perifoveal regions were measured.Visual acuity(VA),visual field index and mean deviation were measured as visual outcomes.RESULTS:The AQP4 group showed a significantly thinner fovea(226.4±13.4μm)relative to the MOG(236.8±14.0μm,P=0.015)and MS(238.9±14.3μm,P=0.007)groups.The thickness in the parafoveal area also was thinner in the AQP4 group,though the difference in perifoveal retinal thickness was not significant.Foveal thickness was correlated with VA in the AQP4 group(coefficientρ=-0.418,P=0.014),but not in the MOG and MS groups(P=0.218 and P=0.138,respectively).There was no significant correlation between foveal thickness and visual field test in all three groups.CONCLUSION:The significant thinning in the fovea and parafoveal areas in the AQP4 group compared to the MOG and MS groups are found.Additionally,macular changes in AQP4-ON show a significant correlation with VA.The results provide the possibility that retinal structural damage could reflect functional damage in AQP4-ON,distinct from MOGON and MS-ON.
基金supported by the Ningbo Leading Medical&Health Discipline(Grant No.2022-B12)Ningbo Natural Science Foundation(Grant No.202003N4240)+1 种基金Hwa Mei Foundation(Grant No.2021HMZY102,Grant No.2022HMKY45)Medical Scientific Research Foundation of Zhejiang Province(Grant No.2023KY1085).
文摘Objective:To evaluate the plasma levels of the otoconial proteins,otoconin-90 and otolin-1,in individuals diagnosed with vestibular neuritis(VN)and determine the feasibility of using these proteins as biomarkers for VN.Methods:In this preliminary study,30 patients diagnosed with VN and 70 healthy individuals were recruited and followed to confirm whether they had benign paroxysmal positional vertigo(BPPV)during the following time.The recorded data included measurements of height,weight,and history of diabetes mellitus or hypertension.Additionally,levels of plasma otoconin-90,and otolin-1 were measured and compared.Results:The plasma concentrations of otoconin-90 and otolin-1 may not be significantly different between patients with VN and healthy controls,nor among patients with BPPV secondary to VN and patients with VN without BPPV.Conclusions:Plasma otoconin-90 and otolin-1 levels may not serve as biomarkers of acute VN episodes or predict BPPV occurrence secondary to VN.
基金Municipal Science and Technology Plan Project of Xingtai City,Hebei Province,No.2022ZC232 and No.2022ZC129.
文摘BACKGROUND A subtype of the Omicron variant of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is suggested to be responsible for the outbreak in Northern China since the quarantine was lifted in December 2022.The coronavirus disease 2019 virus is primarily responsible for the development of respiratory illnesses,however,it can present a plethora of symptoms affecting a myriad of body organs.This virus has been theorized to be linked to demyelinating lesions of the peripheral and central nervous system including transverse myelitis and acute retrobulbar optic neuritis(ARON).For example,magnetic resonance imaging(MRI)of the orbit and brain showed enlargement of the retrobulbar intraorbital segments of the optic nerve with high T2 signal,and no abnormalities were seen in the brain tissue.In this case series,we analyzed the connection between SARSCoV-2 infection and the onset of ARON.CASE SUMMARY Fifteen patients,and a teenage boy who did not have any pre-existing ocular or demyelinating diseases suddenly experienced a loss of vision after SARS-CoV-2 infection.The patients expressed a central scotoma and a fever as the primary concern.The results of the fundus photography were found to be normal.However,the automated perimetry and MRI scans showed evidence of some typical signs.Out of the 15 patients diagnosed with ARON after SARS-CoV-2 infection,only one individual tested positive for the aquaporin-4 antibody.CONCLUSION Direct viral invasion of the central nervous system and an immune-related process are the two primary causes of SARS-CoV-2-related ARON.
文摘Optic neuritis (ON) is a kind of inflammatory disease characterized by optic nerve damage, which can lead to vision loss or even blindness. With the development of ON pathology, the medical community has gained a more comprehensive understanding of its immune-mediated complex processes. In addition, the treatment method has also developed from a single hormone therapy to a variety of treatment strategies including immunosuppressants, plasma exchange, immunoadsorption, etc., and the emerging therapy of stem cell transplantation has become the focus of attention. This review aims to explore the latest pathomechanisms of optic neuritis, comprehensively analyze the current therapeutic research advances, and provide a reference for future therapeutic directions.
文摘Objective To observe the clinical effects of centro-square needling combined with ginger moxibustion on neuritis of lateral cutaneous nerve of thigh. Methods Centro-square needling combined with ginger moxibustion was used in all the thirty-five cases. Ashi points, Xuèhǎi （血海 SP 10）, Zúsānlǐ （足三里 ST 36）, Yīnlíngquán （阴陵泉 SP 9） and Sānyīnjīao （三阴交 SP 6） on affected side were chosen. The treatment frequency was once a day, and a course was 2 weeks. The clinical effects were observed after 2 courses. Results 23 cases got cure, 7 cases were marked effective, 3 cases were effective and 2 were failed in all the 35 cases. The total effective rate was 94.3% （33/35）. Conclusion The centro-square needling combined with ginger moxibustion has obvious effect on neuritis of lateral cutaneous nerve of thigh.
文摘Objective To evaluate the optic nerve impairment using MRI histogram texture analysis in the patients with optic neuritis.Methods The study included 60 patients with optic neuritis and 20 normal controls. The coronal T2 weighted imaging(T2 WI) with fat saturation and enhanced T1 weighted imaging(T1 WI) were performed to evaluate the optic nerve. MRI histogram texture features of the involved optic nerve were measured on the corresponding coronal T2 WI images. The normal optic nerve(NON) was measured in the posterior 1/3 parts of the optic nerve. Kruskal-Wallis one-way ANOVA was used to compare the difference of texture features and receiver operating characteristic(ROC) curve were performed to evaluate the diagnostic value of texture features for the optic nerve impairment among the affected optic nerve with enhancement(ONwEN), affected optic nerve without enhancement(ONwoEN), contralateral normal appearing optic nerve(NAON) and NON. Results The histogram texture Energy and Entropy presented significant differences for ONwEN vs. ONwoEN(both P = 0.000), ONwEN vs. NON(both P = 0.000) and NAON vs. NON(both P < 0.05). ROC analysis demonstrated that the area under the curve(AUC) of histogram texture Energy were 0.758, 0.795 and 0.701 for ONwEN vs. ONwoEN, ONwEN vs. NON and NAON vs. NON, AUC of Entropy were 0.758, 0.795 and 0.707 for ONwEN vs. ONwoEN, ONwEN vs. NON and NAON vs. NON.Conclusion The altered MRI histogram texture Energy and Entropy could be considered as a surrogate for MRI enhancement to evaluate the involved optic nerve and normal-appearing optic nerve in optic neuritis.
文摘A 27 year-old lady,presented with sudden loss of vision in the right eve tor a week.It was followed In poor vision in the left eye alter 3 days.It involved the whole entire visual field and was associated with pain on eye movement.She was diagnosed to have miliary tuberculosis and retroviral disease 4 months ago.She was started on anti-TB since then but defaulted highly active anti-retroviral therapy(HAART).On examination.her visual acuity was no perception of light in the right eye and 6/120(pinhole 3/60) in the lelt eye.Anterior segment in both eyes was unremarkable.Funduscopy showed bilateral optic disc swelling with presence ot multiple foci of choroiditis in the peripheral retina.The vitreous and relinal vessels were normal.Chest radiography was normal.CT scan of orbit and brain revealed bilateral enhancement of the optic nerve sheath that suggest the diagnosis of bilateral atypical optic neuritis.This patient was managed with infectious disease team.She was started on HAART and anti-TB treatment was continued.She completed anti-TB treatment alter 9 months without any serious side effects.During follow up the visual acuity in both eyes was not improved.However.funduscopy showed resolving ol disc swelling and choroiditis following treatment.
基金Supported by the National Natural Science Foundation of China(No.81260149No.81360152No.81560162)
文摘AIM：To determine whether gypenosides have protective effects in experimental autoimmune optic neuritis（EAON）.METHODS：Mice were randomly divided into seven groups：control group,model group,three different density gypenosides monotherapy,methylprednisolone monotherapy,combination of gypenosides and methylprednisolone group.The control group was subcutaneously injected with oil emulsion adjuvant and all other groups were subcutaneously immunized with an emulsified mixture of myelin oligodendrocyte glycoprotein（MOG） 35-55 peptide to induce EAON.Mice in the gypenosides groups were administered injections daily with three concentrations（15 mg/kg,30 mg/kg,45 mg/kg） of gypenosides respectively.Mice in the methylprednisolone group and the combination treatment group were injected daily with methylprednisolone（20 mg/kg） or methylprednisolone（20 mg/kg） ＋ gypenosides（30 mg/kg）,respectively.After MOG immunization,visual evoked potential（VEP）,optical coherence tomography（OCT）,and histopathologic examination were performed at 14,20,30,and 40 d post-inoculation（p.i.）.All results were expressed as mean±SEM.The data were evaluated by oneway ANOVA followed by Tukey or Games-Howell test.RESULTS：Compared with the control group,p2 latency was prolonged in the model group（P=0.041）.Combination treatment can alleviated the change in VEP at 20 d p.i.（P=0.012）.Average peripapillary retinal nerve fiber layer（RNFL） thickness was reduced in the model group（P= 0.000,30d;P=0.000,40d） and gypenosides treatment remarkably diminished the degree of RNFL degenerationat 30 d and 40 d p.i（P=0.000,30d;P=0.000,40d）.The pathomorphological results showed a decrease in demyelination（P=0.020） and inflammatory reactions in the combination group compared with the model group（20d p.i.）.Gypenosides treatment also alleviated the degree of axonal loss（40d p.i.）（P=0.003）.CONCLUSION：Treatment with gypenosides exerts protective effects on retinal nerve fibers and axons in EAON.When combined with gypenosides,methylprednisolone reduces demyelination in the acute stage of EAON.
文摘The diagnosis of the recurrent optic neuritis is commonly established clinically,and sometimes it could be challenging because the involved optic nerve does not always show significant enhancement on conventional contrast enhanced-T1 weighted imaging（CE-T1W1）.In this paper,we reported a middle-aged female with early diagnosis of recurrent optic neuritis using contrast-enhanced T2 fluid-attenuated inversion recovery imaging（CET2FLAIR）.The involved optic nerve presented evident enhancement on CE-T2FLAIR and no enhancement on CE-T1W1.This case suggested that the CE-T2FLAIR may be a useful diagnostic tool specifically for the recurrent optic neuritis in clinical practice.
文摘AIM：To compare the thickness of the peripapillary retinal nerve fiber layer（RNFL）and ganglion cell-inner plexiform layer（GCIPL）among patients with various forms of optic neuritis（ON）and to identify whether any particular parameters or their thinning pattern can be used to distinguish the type of ON.METHODS：This prospective study was conducted at the Department of Ophthalmology,Faculty of Medicine,Siriraj Hospital,Thailand,between January,2015 and December,2016.We enlisted patients over 18 years of age with history of ON and categorized patients into 4 groups：1）aquaporin 4 antibodies（AQP4-IgG）positive;2）multiple sclerosis（MS）;3）myelin oligodendrocyte glycoprotein antibodies（MOG-IgG）positive;4）idiopathic-ON patients.Healthy controls were also included during the same study period.All patients underwent complete ophthalmological examination and spectral domain optical coherence tomography（OCT）imaging to analyze RNFL and GCIPL thickness after at least 3mo since the last episode of acute ON.The generalized estimating equation（GEE）models were used to compare the data amongst ON groups. RESULTS： Among 87 previous ON eyes from 57 patients（43 AQP4-IgG＋ON,17 MS-ON,8 MOG-IgG＋ON,and 19idiopathic-ON）,mean logMAR visual acuity of AQP4-IgG＋ON,MS-ON,MOG-IgG＋ON,and idiopathic-ON groups was 0.76±0.88,0.12±0.25,0.39±0.31,and 0.75±1.08,respectively.Average,superior,and inferior RNFL were significantly reduced in AQP4-IgG＋ON,MOG-IgG＋ON and idiopathic-ON eyes,relative to those of MS-ON.Differences were not statistically significant for RNFL or GCIPL between the AQP4-IgG＋ON and MOG-IgG＋ON groups,whereas visual acuity in MOG-IgG＋ON was slightly,but not significantly,better（0.39 vs 0.76）.Although RNFL thickness in MOG-IgG＋ON was significantly reduced as compared to MS-ON,mean visual acuity and GCIPL were not different.CONCLUSION：Thinning of superior and inferior quadrants of RNFL are more commonly seen in MOG-IgG＋ON and AQP4-IgG＋ON.Long term visual acuity in MOG-IgG＋ON is often better than AQP4-IgG＋ON,whereas the structural change from OCT is comparable.
基金The 12~(th)Five-Year Plan National Science and Technology Support Program,China(No.2012BAI08B06)
文摘AIM:To determine the clinical features,diagnosis and treatment of the primary Sjogren syndrome(SS)related optic neuritis.METHODS:The clinical data of 8 patients(12 eyes)with primary SS related optic neuritis were analyzed retrospectively.RESULTS:Eight of 128 consecutive patients with optic neuritis resulted from varied causes fulfilled the diagnostic criteria for the primary SS.They presented initially with the signs and symptoms of non-specific optic neuritis,and 5 patients presenting without dryness showed a chronic inflammation of submandibular gland or parotid gland,and lymphocyte infiltration was demonstrated by labial gland biopsy in 2 patients.There were serum positive titers for anti-Sjogren syndrome A(SSA)in 7 patients and anti-Sjogren syndrome B(SSB)in 8 patients.Anti-aquaporin-4(AQP4)antibody was negative in all the 8 patients.Both glucocorticoids and immunosuppressive agent were administered,and visual acuity elevated in 8 eyes(66.7%),3 patients(37.5%)recurred in the follow-up.CONCLUSION:Primary SS related optic neuritis is less common and easily misdiagnosed.The conventional therapies for optic neuritis could not control the recurrence.
基金Supported by the National High Technology Research and Development Program of China(863 Programme,No.2015AA020511)Clinical Support Foundation of PLA General Hospital,China(No.2016FC-TSYS-I016)。
文摘AIM: To assess the relationships of final best-corrected visual acuity(BCVA) and the optic nerve structural loss in varying age-cohorts of optic neuritis(ON) patients.METHODS: This is a retrospective, cross-sectional study.Totally 130 ON subjects(200 eyes) without ON onset within 6mo were included, who underwent BCVA assessment,peripapillary retinal nerve fibre layer(pRNFL) and macular segmented layers evaluation by optical coherence tomography(OCT).RESULTS: For the 0-18y cohort, the final BCVA(logMAR)was significantly better and less frequent recurrences than adult cohorts(P=0.000). The final BCVA(logMAR) in all age-cohorts of the ON patients had negative and linear correlations to the pRNFL thicknesses and macular retinal ganglion cell layer(mRGCL) volumes, when the pRNFL thicknesses were reduced to the thresholds of 57.2-67.5 μm or 0.691-0.737 mm;in mRGCL volumes, respectively, with the strongest interdependence in the 19-40y cohort. The ON patients from varying age cohorts would be threatened by blindness when their pRNFL thicknesses dropped 36.7-48.3 μm or the mRGCL volumes dropped to 0.495-0.613 mm;.CONCLUSION: The paediatric ON has best prognosis and young adult ON exhibits perfectly linear correlations of final vision and structural loss. The pRNFL and the mRGCL could be potential structural markers to predict the vision prognosis for varying-age ON patients.
基金Supported by Vision Research National Eye Institute(NEI)P30 EY001792Unrestricted Research to Prevent Blindness(RPB)Departmental Grant
文摘AIM:To elucidate the changes of different ganglion cell layer(GCL)thinning patterns between the optic neuritis(ON)and non-arteritic anterior ischemic optic neuropathy(NAION).METHODS:A prospective,observational study was conducted to evaluate the timing of GCL changes between acute ON and NAION using optical coherence tomography.RESULTS:Thinning on optical coherence tomography in the NAION group occurs as early as 11 d after symptomatic onset of vision loss and follows an altitudinal pattern.The mean superior-inferior GCL thickness difference in the NAION cohort was clinically significant at 5.7μm in the NAION cohort compared to controls of 0.8μm(P=0.032),but not significant in the ON group compared to controls with both groups measuring 1.1μm.Global thinning was significant for the ON group compared to controls at 7.2μm(P=0.011)but not the NAION group compared to controls at 1.35μm.CONCLUSION:These findings suggest that future treatments for NAION should be given early,and possibly before 11 d in order to prevent GCL and irreversible vision loss.
文摘BACKGROUND： Minocycline, a tetracycline derivative, is neuroprotective in models of various neurological diseases. OBJECTIVE： To investigate the effects of minocycline on retinal ganglion cells （RGCs） in rats with optic neuritis, and to compare with the effects of methylprednisolone. DESIGN, TIME AND SETTING： This neuropathology controlled study was performed at the First Affiliated Hospital, Chongqing Medical University, China in May 2007. MATERIALS： A total of 22 female Wistar rats were randomly assigned into a normal control group （n ： 5） and an experimental group （n = 17）. The experimental group was composed of a model subgroup （n = 7）, a minocycline subgroup （n = 5）, and a methylprednisolone subgroup （n = 5）. Minocycline was supplied by Sigma, USA. METHODS： Antigen homogenate made from guinea pig spinal cord and complete Freund adjuvant was used to induce autoimmune encephalomyelitis, which could induce demyelinated optic neuritis models. Rats in the minocycline subgroup were intraperitoneally injected with minocycline （45 mg/kg） daily from day 8 following autoimmunity. Rats in the methylprednisolone subgroup were intraperitoneally injected with methylprednisolone （20 mg/kg） daily from day 8 following autoimmunity. MAIN OUTCOME MEASURES： On day 18 after autoimmunily induction, pathological changes in the optic nerve were observed by hematoxylin-eosin staining. The percentage area of axons in the transverse section of the optic nerve was measured by Bielschowsky staining. Apoptosis of RGCs was detected by TUNEL. RESULTS： Under an optical microscope, the optic nerve in rats with demyelinated optic neuritis showed a vacuole-like structure of fibers, irregular swelling of the axons, and infiltration of a large quantity of inflammatory cells. With an electron microscope, the optic nerve presented with vacuole-like structures in the axons, a small percentage area of axons in the transverse section, loose myelin sheaths, and microtubules and microfilaments disappeared. The pathological changes in the optic nerve met the changes in demyelinated optic neuritis. Moreover, there was significant apoptosis of RGCs. The percentage area of optic nerve axons in the transverse section was significantly increased and the number of apoptotic RGCs was increased after treatment with methylprednisolone and minocycline. Compared with methylprednisolone, minocycline had better effects on reducing RGC apoptosis （P 〈 0.05）. CONCLUSION： Minocycline has better inhibitory effects on RGC apoptosis than methylprednisolone. Minocycline can decrease the damage to axons of demyelinated optic neuritis rats, and has similar protective effects on neurons from demyelinated optic neuritis rats as methylprednisolone.
