Visual dysfunction, but not retinal thinning, following anti-NMDA receptor encephalitis

Area of Science:

• Neuroscience
• Ophthalmology
• Immunology

Background:

• Anti-NMDA receptor (NMDAR) encephalitis is a severe autoimmune condition.
• Visual system involvement can occur, but structural and functional changes are not fully understood.

Purpose of the Study:

• To investigate structural and functional alterations in the afferent visual system post-NMDAR encephalitis.
• To compare visual function and retinal structure in patients with NMDAR encephalitis and healthy controls.

Main Methods:

• Cross-sectional study of 31 NMDAR encephalitis patients and matched controls.
• Visual acuity and low-contrast sensitivity were assessed.
• Optical coherence tomography (OCT) measured retinal nerve fiber layer (pRNFL) and intraretinal layer thicknesses.

Main Results:

• Patients showed reduced high-contrast and low-contrast visual acuity compared to controls.
• Visual acuity deficits correlated with disease severity.
• No significant differences were found in pRNFL or intraretinal layer thicknesses between patients and controls.

Conclusions:

• NMDAR encephalitis leads to mild visual dysfunction without apparent retinal structural changes.
• This may indicate NMDAR dysfunction in the visual pathways or cognitive impairment impacting vision.
• Further research into visual pathway involvement is warranted.