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International Ophthalmology

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01-12-2024 | Optic Neuritis | Original Paper

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

Authors: Madhurima Kaushik, Virna Mahesh Shah, Sharmila Murugesan, Karthik Kumar Mani, Shriram Vardharajan

Published in: International Ophthalmology | Issue 1/2024

Abstract

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.

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Title: Clinical profile and challenges faced in the management of optic neuritis: the Indian scenario
Authors: Madhurima Kaushik
Virna Mahesh Shah
Sharmila Murugesan
Karthik Kumar Mani
Shriram Vardharajan
Publication date: 01-12-2024
Publisher: Springer Netherlands
Keywords: Optic Neuritis
Neuromyelitis Optica Spectrum Disease
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Multiple Sclerosis
Published in: International Ophthalmology / Issue 1/2024
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI: https://doi.org/10.1007/s10792-024-03081-1

At a glance: The STEP trials

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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