Predictors of Poor Visual Outcome in Myelin Oligodendrocyte Glycoprotein-Related Optic Neuritis
| Created | |
|---|---|
| Tags | Neuro |
| Journal | Ophthalmology |
| Status | 審查完成 |
| 校稿者 | 蕭靜熹 醫師 |
Ophthalmology Volume 130, Number 9, September 2023
髓鞘細胞蛋白相關視神經炎中不良視覺結果的預測因素
中文摘要
該研究旨在確定髓鞘細胞蛋白相關視神經炎（Myelin Oligodendrocyte Glycoprotein-Related Optic Neuritis ,MOG-ON）患者中視覺不良結果的比例，以及與這些結果相關的因素。該研究是一項回顧性的病歷審查，涉及48名患者，其中有45名符合納入標準。主要結果指標是不良的視覺結果，其定義為受影響眼的最終中央視力（VA）超過0.4 logMAR，或在視野測試中平均偏差（MD）小於-5.0 dB。
該研究發現42.2％的患者具有不良的視覺結果，這挑戰了目前認為大多數MOG-ON患者能夠實現良好視覺結果的信念。早期使用皮質類固醇治療與較好的視覺結果相關。從症狀發作到治療開始的平均時間在具有良好結果的患者中顯著短於具有不良結果的患者。在預測視覺結果方面，口服皮質類固醇與靜脈內給藥之間的類型差異以及神經影像學特徵之間並未發現顯著差異。
該研究結論是，將近一半的MOG-ON患者具有不良的視覺結果，強調了早期使用皮質類固醇治療的重要性。該研究還發現，口服皮質類固醇與靜脈內給藥相比，在實現良好視覺結果方面具有非劣勢性。沒有神經影像學特徵能夠預測視覺結果。
English Abstract
The study aims to identify the proportion of patients with poor visual outcomes in Myelin Oligodendrocyte Glycoprotein-Related Optic Neuritis (MOG-ON) and the factors associated with these outcomes. The study is a retrospective chart review involving 48 patients, of which 45 met the inclusion criteria. The primary outcome measure was poor visual outcomes, defined as a final central visual acuity (VA) of more than 0.4 logMAR or mean deviation (MD) of less than -5.0 dB on perimetry in the affected eye.
The study found that 42.2% of patients had poor visual outcomes, which challenges the current belief that most MOG-ON patients achieve good visual outcomes. Early treatment with corticosteroids was found to be associated with better visual outcomes. The average time from symptom onset to treatment initiation was significantly shorter in those with good outcomes compared to those with poor outcomes. No significant difference was found in the type of corticosteroid administration (oral vs. intravenous) or neuroradiologic features in predicting visual outcomes.
The study concludes that almost half of the patients with MOG-ON had poor visual outcomes, emphasizing the importance of early treatment with corticosteroids. The study also found that oral corticosteroids were non-inferior to intravenous administration for achieving good visual outcomes. No neuroradiologic feature was predictive of visual outcomes.
