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视觉功能改善后等离子交换治疗急性光学神经炎在神经炎的光学谱系障碍:病例系列和审查

Raluca Iancu¹, Ruxandra Pirvulescu¹, Nicoleta Anton²

¹Department of Ophthalmology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Diagnostics (Basel, Switzerland)

|May 11, 2024

概括

血交换 (PLEX) 有效地改善了由于神经炎光学谱障碍 (NMOSD) 导致严重急性视神经炎 (ON) 的患者的视力,当初始IV甲基prednisolone (IVMP) 治疗失败时. 对于这些具有挑战性的病例,PLEX提供了一种有价值的救援疗法.

科学领域:

神经免疫学神经免疫学
眼科医生眼科眼科
神经学神经学

背景情况:

神经omyelitis optica光谱障碍 (NMOSD) 是一种自身免疫性中枢神经系统疾病,其特征是水-4 IgG抗体 (AQP4-Ab).
严重的视神经炎 (ON) 和横侧髓炎是关键的临床特征,往往导致显著的视力障碍和神经缺陷.
对于一些患有严重ON的NMOSD患者,静脉注射甲基prednisolone (IVMP) 的标准治疗可能不足.

研究的目的:

为了评估NMOSD患者的视觉结果,严重的急性ON不响应IVMP,接受了血交换 (PLEX) 治疗.
评估PLEX作为耐火性AQP4抗体阳性ON的潜在救援疗法.

主要方法:

三名NMOSD患者的病例系列,患有严重的急性ON,对IVMP没有反应.
患者接受了标准化的PLEX协议 (10天的5个周期).
在PLEX后1个月,通过最佳校正的视敏度 (BCVA) 和视野 (VF) 参数来评估视觉结果.

主要成果:

这三名患者均为AQP4-Ab血清阳性;其中一人也是MOG-Ab阳性.
轨道核磁共振扫描显示了脑后,眼和/或内部分的病变.
在接受PLEX治疗后,所有患者在1个月后,BCVA和VF参数均有所改善.

结论:

血交换 (PLEX) 可以是一个有效的救援治疗严重的急性ON在NMOSD患者耐药IVMP.
普雷克斯治疗似乎改善了AQP4-ON患者第一次发作的视觉结果.
这项研究支持在初始高剂量IVMP不足时考虑PLEX治疗NMOSD相关的急性ON.

关键词:

神经脊髓炎光学谱系障碍视神经炎是一种视神经炎.血交换疗法是一种血交换疗法.视觉功能视觉功能视觉功能

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