Clinical profile and challenges faced in the management of optic neuritis: the Indian scenario.

Autor: Kaushik M; Neuro-Ophthalmology Services, Aravind Eye Hospital, Avinashi Road, Coimbatore, Tamil Nadu, 641014, India., Shah VM; Neuro-Ophthalmology Services, Aravind Eye Hospital, Avinashi Road, Coimbatore, Tamil Nadu, 641014, India. virna@aravind.org., Murugesan S; Neuro-Ophthalmology Services, Aravind Eye Hospital, Avinashi Road, Coimbatore, Tamil Nadu, 641014, India., Mani KK; Neuro-Ophthalmology Services, Aravind Eye Hospital, Avinashi Road, Coimbatore, Tamil Nadu, 641014, India., Vardharajan S; Department of Imaging Sciences and Interventional Radiology, Kovai Medical Center and Hospital, Coimbatore, Tamil Nadu, 641014, India.
Jazyk: angličtina
Zdroj: International ophthalmology [Int Ophthalmol] 2024 Mar 15; Vol. 44 (1), pp. 138. Date of Electronic Publication: 2024 Mar 15.
DOI: 10.1007/s10792-024-03081-1
Abstrakt: Purpose: Optic neuritis (ON) is a relatively common ophthalmic disease that has recently received renewed attention owing to immunological breakthroughs. We studied the profile of patients with ON with special reference to antibody-mediated ON and the challenges faced in its management.
Methods: Case records of patients with ON presenting to a tertiary eye-care center in South India were analyzed. Data on demographics, presenting visual acuity (VA), clinical features, seropositivity for aquaporin-4 immunoglobulin G (AQP4-IgG) and myelin oligodendrocyte glycoprotein immunoglobulin G (MOG-IgG), details of magnetic resonance imaging (MRI) of orbits and brain, and treatment were collected.
Results: Among 138 cases with acute ON, male: female ratio was 1:2. Isolated ON was present in 41.3% of cases. Antibody testing of sera was performed in 68 patients only due to financial limitations. Among these, 48.5% were MOG-IgG-seropositive, 11.76% were AQP4-IgG-seropositive, and 30.88% samples were double seronegative. Other causes included multiple sclerosis (n = 4), lactational ON (n = 4), tuberculosis (n = 2), invasive perineuritis (n = 2), COVID-19 vaccination (n = 2), and COVID-19 (n = 1). The mean presenting best corrected visual acuity (BCVA) was 1.31 ± 1.16 logMAR (logarithm of the minimum angle of resolution). The mean BCVA at 3 months was 0.167 ± 0.46 logMAR. Only initial VA ≤ 'Counting fingers' (CF) had a significant association with the visual outcome for final VA worse than CF. The steep cost of investigations and treatment posed challenges for many patients in the management of ON.
Conclusion: MOG-IgG-associated ON is common in India. Unfortunately, financial constraints delay the diagnosis and timely management of ON, adversely affecting the outcome.
(© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)
Databáze: MEDLINE
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