Clinical difference after the first optic neuritis between aquaporin-4-IgG-associated and myelin oligodendrocyte glycoprotein-IgG-associated disorders
Clinical difference after the first optic neuritis between aquaporin-4-IgG-associated and myelin oligodendrocyte glycoprotein-IgG-associated disorders
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DOI：
10.1007/s00415-021-10764-7
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发表时间：
2021-08-29
影响因子：
6
通讯作者：
Kuwabara, Satoshi
中科院分区：
文献类型：
--
作者：
Masuda, Hiroki;Mori, Masahiro;Kuwabara, Satoshi
目的探讨水通道蛋白4 IgG相关性疾病（AQPAD）和髓鞘少突胶质细胞IgG相关性疾病（MOGAD）在首次视神经炎（ON）后病程中的差异。通过回顾性队列研究监测首次ON后前6个月的临床病程。分别于发病前、最低点、2周（2 W）、1个月（1 M）、2个月（2 M）、3个月（3 M）、6个月（6 M）观察最佳矫正视力（BCVA）。将十进制BCVA转换为最小分辨角（logMAR）的对数，以进行统计分析。结果MOGAD眼从ON至最低点（6.0 vs. 11.5，P = 0.012）和至治疗（7.0 vs. 11.0，P = 0.020）的中位天数均长于AQPAD眼。在最低点（2.00 vs. 1.77，P = 0.050）、2 W（1.85 vs. 0.40，P = 0.001）、2 M（0.023 vs. - 0.079，P = 0.032）和3 M（0.046 vs. -0.079，P = 0.002）时，AQPAD眼的中位logMAR高于MOGAD眼。AQPAD眼BCVA恢复至0.7的中位时间长于MOGAD眼（44.0 vs. 21.0天，P = 0.024），但两种疾病之间BCVA恢复至1.0的中位时间无差异（分别为168.0 vs. 40.0天，P = 0.056）。结论与MOGAD眼相比，AQPAD眼即使在首次ON发作时也有视力下降的趋势。
Objective To investigate the difference in clinical course after the first optic neuritis (ON) between aquaporin-4 IgG-associated disorder (AQPAD) and myelin oligodendrocyte glycoprotein-IgG-associated disorder (MOGAD) Methods In this study, 31 eyes in 24 patients with AQPAD and 26 eyes in 18 patients with MOGAD were included. The clinical course for the first 6 months after the first ON was monitored by a retrospective cohort study. Best-corrected visual acuity (BCVA) was observed before the onset and at nadir, 2 weeks (2 W), 1 month (1 M), 2 months (2 M), 3 months (3 M) and 6 months (6 M). The decimal BCVA was converted to the logarithm of the minimal angle of resolution (logMAR) for statistical analyses. Results MOGAD eyes showed longer median number of days from ON onset to nadir (6.0 vs. 11.5, P = 0.012) and to treatment (7.0 vs. 11.0, P = 0.020) than AQPAD eyes. The median logMAR was higher in AQPAD eyes than in MOGAD eyes at nadir (2.00 vs. 1.77, P = 0.050), 2 W (1.85 vs. 0.40, P = 0.001), 2 M (0.023 vs. - 0.079, P = 0.032) and 3 M (0.046 vs. - 0.079, P = 0.002). The median time to recovery of BCVA to 0.7 was longer in AQPAD eyes than in MOGAD eyes (44.0 vs. 21.0 days, P = 0.024), but that to BCVA 1.0 was not different between the two disorders (168.0 vs. 40.0 days, respectively, P = 0.056). Conclusion Compared with MOGAD eyes, AQPAD eyes tended to show worse visual outcome even during the first ON episode.