RT Journal Article
SR Electronic
T1 Distinct clinical characteristics of atypical optic neuritis with seronegative aquaporin-4 antibody among Chinese patients
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP 1720
OP 1724
DO 10.1136/bjophthalmol-2017-310157
VO 101
IS 12
A1 Huanfen Zhou
A1 Quangang Xu
A1 Shuo Zhao
A1 Wei Wang
A1 Junqing Wang
A1 Zhiye Chen
A1 Dahe Lin
A1 Xiaoming Li
A1 Chunxia Peng
A1 Nanping Ai
A1 Shihui Wei
YR 2017
UL http://bjo.bmj.com/content/101/12/1720.abstract
AB Objective To evaluate the clinical features and prognosis of atypical optic neuritis (ON) with seronegative aquaporin-4 (AQP4) antibody in Chinese patients.Methods All patients with first or relapsing ON were recruited from the Neuro-ophthalmology Department of the Chinese People’s Liberation Army General Hospital from January 2013 to December 2014 and assigned to one of three groups based on diagnosis: atypical ON, typical ON and neuromyelitis optica spectrum disorder (NMOSD)-ON.Results A total of 173 patients were included in the cohort. Fifty patients (28.9%) were AQP4-Ab-positive and diagnosed with NMOSD-ON. Of 123 patients with seronegative AQP4-Ab, 37 (30.1%) patients had atypical ON, with male predominance (25, 67.6%). The atypical ON group (compared with the typical ON and NMOSD-ON groups) had a significantly lower female:male ratio (1:2.1 vs 1.8:1 and 9:1, respectively, p=0.001 and p<0.001), an older mean age of onset (44.8, 13–71 years vs 36.9, 13–73 years and 36.2, 13–66 years, p=0.003 and p=0.004), a lower rate of good (≥0.5) visual recovery (6.7% vs 79.8% and 30.9%, p<0.001 and p<0.001) and (compared with the NMOSD-ON group) a lower recurrence rate during a 2-year follow-up (29.3% vs 60%, p=0.009). However, none developed to multiple sclerosis or neuromyelitis optica in the atypical ON group.Conclusions Atypical ON with seronegative AQP4-Ab had unique clinical features in this Chinese cohort, including male predominance, an older age of onset, worse visual acuity recovery and resistance to corticosteroid therapy. This condition may be a distinct nosological entity with an unusual clinical and therapeutic profile.