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Neurological Sciences

20-11-2023 | Optic Neuritis | Original Article

Clinical features and visual prognosis of very late-onset neuromyelitis optica spectrum disorder–related optic neuritis

Authors: Qinglin Yang, Chuntao Lai, Chao Meng, Qinglin Chang, Na Wei, Jiawei Wang

Published in: Neurological Sciences

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Abstract

Background

Very late-onset neuromyelitis optica spectrum disorder–related optic neuritis is limited to a few case reports.

Objective

To investigate the clinical features and visual prognosis of very late-onset neuromyelitis optica spectrum disorder–related optic neuritis.

Methods

This study evaluated 22 patients with first-onset optic neuritis and fulfilled the 2015 diagnosis criteria for neuromyelitis optica spectrum disorders.

Results

The mean age at optic neuritis onset was 73.91 ± 4.71 (range: 70–82) years with a female predominance (81.8%; ratio: 4.5:1). Antinuclear antibody seropositivity and seronegativity were identified in 12 (55.5%) and 10 (45.5%) patients, respectively. Severe visual loss persisted in 19 (19/42, 45.3%) eyes at the last follow-up. Although patients with antinuclear antibody seropositivity had a significantly higher frequency of attacks (P = 0.015), but they had a longer median time to reach severe visual loss (37 vs. 26 months; log-rank test, P = 0.023). Multivariate logistic regression analysis revealed antinuclear antibody seropositivity (hazard ratio = 4.849, 95% confidence interval: 1.309–17.965, P = 0.018) as a good predictor of visual acuity improvement.

Conclusion

Patients with very late-onset neuromyelitis optica spectrum disorder–related optic neuritis may develop severe optic neuritis, and those with antinuclear antibody seronegativity have a similar clinical presentation but worse outcome than those with seropositivity.
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Metadata
Title
Clinical features and visual prognosis of very late-onset neuromyelitis optica spectrum disorder–related optic neuritis
Authors
Qinglin Yang
Chuntao Lai
Chao Meng
Qinglin Chang
Na Wei
Jiawei Wang
Publication date
20-11-2023
Publisher
Springer International Publishing
Published in
Neurological Sciences
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-023-07187-9