Korean J Ophthalmol.  2019 Feb;33(1):82-90. 10.3341/kjo.2018.0050.

Association of Optic Neuritis with Neuromyelitis Optica Spectrum Disorder and Multiple Sclerosis in Korea

• Kim H
• Park KA
• Oh SY
• Min JH
• Kim BJ

• KMID: 2434308
• DOI: http://doi.org/10.3341/kjo.2018.0050

Abstract

PURPOSE
To describe the clinical characteristics and course of optic neuritis (ON) and its association with neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) in Korea.
METHODS
In this retrospective case series, 125 eyes of 91 Korean patients with ON were included. The medical documents of adult patients with ON were retrospectively reviewed. Patients were assigned into idiopathic ON, NMOSD, and MS groups according to the presence of an association with NMOSD or MS for subgroup analysis. Clinical characteristics, disease course, and visual and systemic prognosis were analyzed.
RESULTS
During the mean follow-up of 3.7 years, 73 patients were diagnosed as idiopathic ON, 14 patients were diagnosed as NMOSD, and four patients developed definite MS. At the final visit, there were 13 (13%) eyes out of 100 eyes with idiopathic ON, nine (43%) eyes out of 21 eyes with NMOSD, and one (25%) eye out of four eyes with MS had a severe visual loss of 20 / 200 or less. The mean Expanded Disability Status Scale was 3.1 ± 1.5 in NMOSD and 1.8 ± 1.5 in the MS group at the final visit. In the NMOSD group, 50% of patients showed severe visual loss in at least one eye or were unable to ambulate without assistance at the final visit (5.3 ± 4.4 years after the initial episode of ON).
CONCLUSIONS
Fourteen percent of patients showed positive results for NMO-immunoglobulin G test and 50% of patients with NMOSD showed a severe visual loss in at least one eye or were unable to ambulate without assistance. The proportion of MS was relatively low in Korean ON patients.

Keyword

Korea; Multiple sclerosis; Neuromyelitis optica; Optic neuritis

MeSH Terms

Adult
Follow-Up Studies
Humans
Korea*
Multiple Sclerosis*
Neuromyelitis Optica*
Optic Neuritis*
Prognosis
Retrospective Studies

Figure

• 

  Fig. 1 Neuromyelitis optica-immunoglobulin G (NMO-IgG) test positivity before and after 2011. Before 2011 when NMO-IgG was not checked routinely in optic neuritis patients, 13 of 91 patients (14%) patients had positive results for the NMO-IgG test. Among 49 patients who underwent the NMO-IgG test, 13 (27%) were positive. After 2011 when we started to check NMO-IgG routinely in optic neuritis patients, 7 (17%) patients showed positive results. However, of 42 patients who visited after 2011, seven patients did not undergo the NMO-IgG test. Among 35 patients who underwent the NMO-IgG test, seven (20%) patients had positive results for the NMO-IgG test.

Reference

1. Rodriguez M, Siva A, Cross SA, et al. Optic neuritis: a population-based study in Olmsted County, Minnesota. Neurology. 1995; 45:244–250.

2. Wakakura M, Minei-Higa R, Oono S, et al. Baseline features of idiopathic optic neuritis as determined by a multicenter treatment trial in Japan. Optic Neuritis Treatment Trial Multicenter Cooperative Research Group (ONMRG). Jpn J Ophthalmol. 1999; 43:127–132.

3. Du Y, Yang J, Li JJ, et al. Unilateral optic neuritis in a Chinese population in three centers. J Clin Neurosci. 2011; 18:902–904.

4. Wang JC, Tow S, Aung T, et al. The presentation, aetiology, management and outcome of optic neuritis in an Asian population. Clin Exp Ophthalmol. 2001; 29:312–315.

5. Lim SA, Sitoh YY, Chng SM, et al. Magnetic resonance imaging in acute optic neuritis in Singapore. Ann Acad Med Singapore. 2009; 38:821–826.

6. Bee YS, Lin MC, Wang CC, Sheu SJ. Optic neuritis: clinical analysis of 27 cases. Kaohsiung J Med Sci. 2003; 19:105–112.

7. Du Y, Lin YC, He JF. The etiology of optic neuritis in Asian population. Med Hypotheses. 2008; 71:821–822.

8. Wingerchuk DM, Lennon VA, Lucchinetti CF, et al. The spectrum of neuromyelitis optica. Lancet Neurol. 2007; 6:805–815.

9. Benamer HT, Ahmed ES, Al-Din AS, Grosset DG. Frequency and clinical patterns of multiple sclerosis in Arab countries: a systematic review. J Neurol Sci. 2009; 278:1–4.

10. Cabre P, Heinzlef O, Merle H, et al. MS and neuromyelitis optica in Martinique (French West Indies). Neurology. 2001; 56:507–514.

11. Chopra JS, Radhakrishnan K, Sawhney BB, et al. Multiple sclerosis in North-West India. Acta Neurol Scand. 1980; 62:312–321.

12. Kira J. Multiple sclerosis in the Japanese population. Lancet Neurol. 2003; 2:117–127.

13. Papais-Alvarenga RM, Miranda-Santos CM, Puccioni-Sohler M, et al. Optic neuromyelitis syndrome in Brazilian patients. J Neurol Neurosurg Psychiatry. 2002; 73:429–435.

14. Wingerchuk DM, Banwell B, Bennett JL, et al. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology. 2015; 85:177–189.

15. Polman CH, Reingold SC, Banwell B, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011; 69:292–302.

16. Kang ES, Min JH, Lee KH, Kim BJ. Clinical usefulness of cell-based indirect immunofluorescence assay for the detection of aquaporin-4 antibodies in neuromyelitis optica spectrum disorder. Ann Lab Med. 2012; 32:331–338.

17. McDonald WI, Compston A, Edan G, et al. Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol. 2001; 50:121–127.

18. Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983; 33:1444–1452.

19. The clinical profile of optic neuritis. Experience of the optic neuritis treatment trial. Optic Neuritis Study Group. Arch Ophthalmol. 1991; 109:1673–1678.

20. Smith CH. Optic neuritis. In : Miller NR, Newman NJ, Biousse V, Kerrison JB, editors. Walsh and Hoyt's clinical neuro-ophthalmology. 6th ed. Baltimore: Lippincott Williams & Wilkins;2005. p. 293–262.

21. Kennedy C, Carroll FD. Optic neuritis in children. Arch Ophthalmol. 1960; 63:747–755.

22. Beck RW, Cleary PA. Optic neuritis treatment trial. One-year follow-up results. Arch Ophthalmol. 1993; 111:773–775.

23. Beck RW, Cleary PA, Backlund JC. The course of visual recovery after optic neuritis. Experience of the Optic Neuritis Treatment Trial. Ophthalmology. 1994; 101:1771–1778.

24. Kupersmith MJ, Gal RL, Beck RW, et al. Visual function at baseline and 1 month in acute optic neuritis: predictors of visual outcome. Neurology. 2007; 69:508–514.

25. Kezuka T, Usui Y, Yamakawa N, et al. Relationship between NMO-antibody and anti-MOG antibody in optic neuritis. J Neuroophthalmol. 2012; 32:107–110.

26. Kitley J, Waters P, Woodhall M, et al. Neuromyelitis optica spectrum disorders with aquaporin-4 and myelin-oligodendrocyte glycoprotein antibodies: a comparative study. JAMA Neurol. 2014; 71:276–283.