Prognostic factors of first-onset optic neuritis based on diagnostic criteria and antibody status: a multicentre analysis of 427 eyes

Young Gi Min, Yeji Moon, Young Nam Kwon, Byung Joo Lee, Kyung Ah Park, Jae Yong Han, Jinu Han, Haeng Jin Lee, Seol Hee Baek, Byung Jo Kim, Jun Soon Kim, Kyung Seok Park, Nam Hee Kim, Martha Kim, Tai Seung Nam, Seong Il Oh, Jae Ho Jung, Jung Joon Sung, Myoung Jin Jang, Seong Joon KimSung Min Kim

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Background Optic neuritis (ON) prognosis is influenced by various factors including attack severity, underlying aetiologies, treatments and consequences of previous episodes. This study, conducted on a large cohort of first ON episodes, aimed to identify unique prognostic factors for each ON subtype, while excluding any potential influence from pre-existing sequelae. Methods Patients experiencing their first ON episodes, with complete aquaporin-4 (AQP4) and myelin oligodendrocyte glycoprotein (MOG) antibody testing, and clinical data for applying multiple sclerosis (MS) diagnostic criteria, were enrolled. 427 eyes from 355 patients from 10 hospitals were categorised into four subgroups: neuromyelitis optica with AQP4 IgG (NMOSD-ON), MOG antibody-associated disease (MOGAD-ON), ON in MS (MS-ON) or idiopathic ON (ION). Prognostic factors linked to complete recovery (regaining 20/20 visual acuity (VA)) or moderate recovery (regaining 20/40 VA) were assessed through multivariable Cox regression analysis. Results VA at nadir emerged as a robust prognostic factor for both complete and moderate recovery, spanning all ON subtypes. Early intravenous methylprednisolone (IVMP) was associated with enhanced complete recovery in NMOSD-ON and MOGAD-ON, but not in MS-ON or ION. Interestingly, in NMOSD-ON, even a slight IVMP delay in IVMP by >3 days had a significant negative impact, whereas a moderate delay up to 7-9 days was permissible in MOGAD-ON. Female sex predicted poor recovery in MOGAD-ON, while older age hindered moderate recovery in NMOSD-ON and ION. Conclusion This comprehensive multicentre analysis on first-onset ON unveils subtype-specific prognostic factors. These insights will assist tailored treatment strategies and patient counselling for ON.

Original languageEnglish
Pages (from-to)753-760
Number of pages8
JournalJournal of Neurology, Neurosurgery and Psychiatry
Volume95
Issue number8
DOIs
StatePublished - 15 Jul 2024

Keywords

  • CLINICAL NEUROLOGY
  • NEUROIMMUNOLOGY
  • OPHTHALMOLOGY

Fingerprint

Dive into the research topics of 'Prognostic factors of first-onset optic neuritis based on diagnostic criteria and antibody status: a multicentre analysis of 427 eyes'. Together they form a unique fingerprint.

Cite this