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Dynamic Visual Tests to Identify and Quantify Visual Damage and Repair Following Demyelination in Optic Neuritis Patients
Published on: April 14, 2014
14.1K
Big Data Analysis of Inflammatory Conditions Associated With Optic Neuritis
James B Davis1, Amanda D Henderson, Andrew R Carey
1Division of Neuro-ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Summary
Optic neuritis (ON) is strongly linked to neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). High suspicion for ON is crucial in patients with NMOSD or MOGAD, and these conditions should be considered for patients with ON.
Area of Science:
- Neuro-immunology
- Ophthalmology
- Neurology
Background:
- Multiple sclerosis (MS) is a known cause of optic neuritis (ON).
- Other inflammatory conditions like neuromyelitis optica spectrum disorder (NMOSD), myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), and lupus can also cause ON.
- Prospective studies on the risk of ON in these conditions are limited.
Purpose of the Study:
- To determine the frequency and relative risk of optic neuritis (ON) associated with systemic inflammatory conditions.
- To evaluate the prevalence of ON in patients diagnosed with NMOSD, MOGAD, MS, and other relevant diseases.
- To inform diagnostic workup for patients presenting with ON.
Main Methods:
- Retrospective analysis of 6.7 million deidentified electronic medical records from a tertiary care center.
- Identification of ON cases and co-occurring rheumatologic/neuro-inflammatory diseases.
- Calculation of disease frequencies, ON prevalence, and relative risk (RR).
Main Results:
- Optic neuritis (ON) was identified in 5,344 cases.
- Multiple sclerosis (MS) was the most common cause of ON (20.6%), followed by NMOSD (10.5%).
- High prevalence of ON was observed in NMOSD (98.4%), MOGAD (53.3%), and MS (10.0%). NMOSD, MOGAD, and MS showed significantly elevated relative risks (RR) for ON.
Conclusions:
- High relative risk for ON in NMOSD and MOGAD necessitates high clinical suspicion for ON in patients with these conditions.
- MS and NMOSD should be primary considerations in the differential diagnosis for patients presenting with ON.
- These findings underscore the importance of considering specific neuro-inflammatory diseases in the workup of optic neuritis.
