Optic neuritis: a 5-year follow-up study of Chinese patients based on aquaporin-4 antibody status and ages

• Published in: Journal of neurology Vol. 263; no. 7; pp. 1382 - 1389
• Main Authors: Zhou, Huanfen, Zhao, Shuo, Yin, Dongfang, Chen, Xiaofei, Xu, Quangang, Chen, Tingjun, Li, Xiaoyan, Wang, Junqing, Li, Hongyang, Peng, Chunxia, Lin, Dahe, Wei, Shihui
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.07.2016; Springer Nature B.V
• Subjects: Adolescent; Adult; Age; Aged; Antibodies; Antibodies - blood; Aquaporin 4 - immunology; Aquaporins; China; Disease Progression; Female; Humans; Logistic Models; Longitudinal Studies; Male; Medicine; Medicine & Public Health; Middle Aged; Multiple sclerosis; Myelitis, Transverse - blood; Neurology; Neuroradiology; Neurosciences; Ophthalmology; Optic Neuritis - immunology; Optic Neuritis - metabolism; Optic Neuritis - physiopathology; Original Communication; Visual Acuity - physiology; Young Adult; Young adults; Beijing China; China; Multiple sclerosis; Neuromyelitis optica; Aquaporin-4 antibody; Optic neuritis
• ISSN: 0340-5354; 1432-1459
• DOI: 10.1007/s00415-016-8155-7

Little work has been performed on the long-term outcome of optic neuritis (ON) according to the status of aquaporin-4 antibody (AQP4-Ab) and long-term prognosis in older patients in China. This study retrospectively analyzed medical records in a cohort of Chinese patients with 5-year follow-up according to AQP4-Ab status and ages from January 2009 to December 2010. The clinical features, laboratory findings and risk factors for prognosis were analyzed. A total of 128 ON patients were included, 66.4 % of whom were female. The median age at onset was 36.8 years (range 18–73). Serum AQP4-Ab was positive in 45 (35.2 %) patients, with greater frequency in the female, bilateral, and recurrent ON groups (48.2, 42.5 and 53.6 %, respectively). Seropositive AQP4-Ab ON patients had worse visual recovery compared to seronegative patients ( p  = 0.033). The average and four quadrants of retinal nerve fiber layer (RNFL) thickness were significantly thinner in the seropositive group than in the seronegative group ( p  < 0.05). At 5-year follow-up, the ON recurrence rate was higher in the seropositive AQP4-Ab patients (37/45, 82.3 %) than in the seronegative patients (35/83, 42.2 %, p  < 0.001). Among the seropositive patients, 40 % (18/45) developed neuromyelitis optica (NMO). Only 1.2 % (1/83) of the seronegative patients developed NMO and 4.8 % (4/83) developed to MS. Further, the multivariate analysis in seropositive AQP4-Ab patients showed that two risk factors for transverse myelitis (TM) episode were ocular pain and recurrence within 1 year. The older patients had worse visual outcome after the first episode of ON than the younger patients ( p  = 0.007). However, the two groups did not differ significantly with regard to prevalence of AQP4-Ab, long-term visual recovery and the risk of developing to NMO/MS.