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. 2023 Feb 28;7(1):16.
doi: 10.3390/vision7010016.

A 10-Year Single-Center Study of the Clinical Characteristics of Optic Neuritis-Related NMOSD, MS, and Double Seronegative Optic Neuritis, Together with Factors Predicting Visual Outcomes

Parinee Kemchoknatee  1 , Chotika Singhakul  1 , Niracha Arjkongharn  1 , Methaphon Chainakul  1 , Duanghathai Tangon  2 , Thansit Srisombut  1   2
Affiliations

A 10-Year Single-Center Study of the Clinical Characteristics of Optic Neuritis-Related NMOSD, MS, and Double Seronegative Optic Neuritis, Together with Factors Predicting Visual Outcomes

Parinee Kemchoknatee et al. Vision (Basel). .

Abstract

The clinical characteristics of three types of optic neuritis (double seronegative optic neuritis; DN-ON, Neuromyelitis optica spectrum disorder-related optic neuritis; NMOSD-ON, and multiple sclerosis-related optic neuritis; MS-ON) were examined in order to identify factors that may affect good visual recovery in Thai patients. The study included patients diagnosed with three types of optic neuritis at Rajavithi Hospital between 2011 and 2020. Visual acuity at the end of 12 months was used as the treatment outcome. Multiple logistic regression analysis was used to evaluate potential predictors of good visual recovery. Of the 76 patients, 61 had optic neuritis, with DN-ON as the most common subtype (52.6%). MS-ON patients were significantly younger (28.3 ± 6.6 years, p = 0.002) and there was a female predominance in all subgroups (p = 0.076). NMOSD-ON patients had a significantly higher proportion of poor baseline VA (p < 0.001). None of the NMOSD-ON patients achieved 0.3 logMAR visual recovery in the 12-month period (p = 0.022). A delay in treatment with intravenous methylprednisolone (IVMP) for more than 7 days increased the risk of failure to gain 0.3 logMAR visual recovery by five times (OR 5.29, 95% CI 1.359-20.616, p = 0.016), with NMOSD-ON as the strongest predictor (OR 10.47, 95% CI; 1.095-99.993, p = 0.041). Early treatment with intravenous methylprednisolone may be important for achieving at least 0.3 logMAR visual recovery in Thai patients with optic neuritis.

Keywords: multiple sclerosis; neuromyelitis optica spectrum disorder; optic neuritis; visual acuity.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(a) Each orbital MRI scan was composed of five segments: orbital optic nerve (blue), intracanalicular optic nerve (green), intracranial optic nerve (red), optic chiasm (yellow), and optic tract (purple). (b) MRI T1W scan of a female patient diagnosed with double seronegative optic neuritis showed an orbital and intracanalicular optic nerve enhancement (arrows).
Figure 2
Figure 2
A female patient diagnosed with NMOSD-ON. Her MRI T2W scan showed an enhancing lesion of optic nerve at left intraorbital and optic chiasm (arrows).
See this image and copyright information in PMC

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