scholarly journals Use of corticosteroid sparing systemic immunosuppression for treatment of corticosteroid dependent optic neuritis not associated with demyelinating disease

2004 ◽  
Vol 88 (5) ◽  
pp. 673-680 ◽  
Author(s):  
T D Myers
Keyword(s):  
Optic Neuritis ◽  
Demyelinating Disease ◽  
Systemic Immunosuppression

scholarly journals Psychiatric disorders in multiple sclerosis patients

2009 ◽  
Vol 67 (3a) ◽  
pp. 664-667 ◽  
Author(s):  
Mirella Martins Fazzito ◽  
Sérgio Semeraro Jordy ◽  
Charles Peter Tilbery
Keyword(s):  
Multiple Sclerosis ◽  
Psychiatric Disorder ◽  
Optic Neuritis ◽  
Psychiatric Disorders ◽  
Clinical Presentation ◽  
Demyelinating Disease ◽  
Common Symptom ◽  
Multiple Sclerosis Patients ◽  
Variable Clinical Presentation

Multiple sclerosis (MS) is a demyelinating disease showing variable clinical presentation. Optic neuritis is the most common symptom, followed by motor and sensitive manifestations. It is known that this disease may be related to several psychiatric disorders, especially depression. In this study we will discribe 5 cases of MS patients harboring psychiatric disorder related or unchained by the disease itself.

scholarly journals Mitochondrial Uncoupler Prodrug of 2,4-Dinitrophenol, MP201, Prevents Neuronal Damage and Preserves Vision in Experimental Optic Neuritis

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Reas S. Khan ◽  
Kimberly Dine ◽  
John G. Geisler ◽  
Kenneth S. Shindler
Keyword(s):  
Optic Neuritis ◽  
Demyelinating Disease ◽  
Ganglion Cells ◽  
Neuronal Damage ◽  
Neuroprotective Effect ◽  
High Dose ◽  
Axonal Loss ◽  
Mitochondrial Uncoupling ◽  
The Central Nervous System ◽  
Mitochondrial Uncoupler

The ability of novel mitochondrial uncoupler prodrug of 2,4-dinitrophenol (DNP), MP201, to prevent neuronal damage and preserve visual function in an experimental autoimmune encephalomyelitis (EAE) model of optic neuritis was evaluated. Optic nerve inflammation, demyelination, and axonal loss are prominent features of optic neuritis, an inflammatory optic neuropathy often associated with the central nervous system demyelinating disease multiple sclerosis. Currently, optic neuritis is frequently treated with high-dose corticosteroids, but treatment fails to prevent permanent neuronal damage and associated vision changes that occur as optic neuritis resolves, thus suggesting that additional therapies are required. MP201 administered orally, once per day, attenuated visual dysfunction, preserved retinal ganglion cells (RGCs), and reduced RGC axonal loss and demyelination in the optic nerves of EAE mice, with limited effects on inflammation. The prominent mild mitochondrial uncoupling properties of MP201, with slow elimination of DNP, may contribute to the neuroprotective effect by modulating the entire mitochondria’s physiology directly. Results suggest that MP201 is a potential novel treatment for optic neuritis.

Retinal nerve fiber thickness in inflammatory demyelinating diseases of childhood onset

2009 ◽  
Vol 15 (7) ◽  
pp. 802-810 ◽  
Author(s):  
EA Yeh ◽  
B Weinstock-Guttman ◽  
N Lincoff ◽  
J Reynolds ◽  
A Weinstock ◽  
...  
Keyword(s):  
Optic Neuritis ◽  
Nerve Fiber ◽  
Demyelinating Disease ◽  
Transverse Myelitis ◽  
Demyelinating Diseases ◽  
Healthy Controls ◽  
Fiber Layer ◽  
Cross Sectional ◽  
Low Contrast ◽  
Retinal Nerve Fiber

Purpose To evaluate retinal nerve fiber layer thickness (RNFLT) using optical coherence tomography (OCT) in children with acquired demyelinating diseases. Methods This is a cross-sectional study of patients seen between 2006–2008 at the Pediatric MS Center of the Jacobs Neurological Institute. Consensus definitions for pediatric demyelinating disease were followed. All children received OCT testing and assessment of visual acuity (VA) using Snellen and low contrast letter acuity (LCLA) charts. Results Thirty-eight children diagnosed with acquired demyelinating disease, 15 healthy controls, and five children with other neurological disorders (OND) were included. Average RNFLT in healthy controls was 107 ± 12 μm( n = 30) versus 108 ± 5 μm ( n = 10) in OND controls. In children with multiple sclerosis, average RNFLT ± SD was 99 ± 14 μm in unaffected ( n = 24) versus 83 ± 12 μmin eyes affected by optic neuritis (“affected eyes”) ( n = 10). Average RNFLT in children with acute disseminated encephalomyelitis and transverse myelitis was 102 ± 15 μm in unaffected ( n = 18) versus 67 ± 17 μm in affected eyes ( n = 6). In children with optic neuritis (ON), average RNFLT ± SD was 97 ± 13 μm in unaffected ( n = 5) versus 89 ± 12 μm in affected eyes ( n = 9). Differences between children with demyelinating disease and controls and between ON and nonON eyes were statistically significant ( P < 0.001). Bivariate correlations of RNFLT with LCLA ( P = 0.002) and VA ( P < 0.001) were significant. Conclusions OCT may be a valuable tool for the assessment and monitoring of anterior optic pathway dysfunction in children with demyelinating diseases.

scholarly journals Clinical Characteristics, Treatment Outcomes and Predictive Factors in Optic Neuritis

2018 ◽  
Vol 12 (1) ◽  
pp. 247-255 ◽  
Author(s):  
Linda Hansapinyo ◽  
Chayanee Vivattanaseth
Keyword(s):  
Optic Neuritis ◽  
Treatment Outcomes ◽  
Predictive Factors ◽  
Clinical Characteristics ◽  
Demyelinating Disease ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Thai Population ◽  
Visual Outcomes ◽  
Clinical Presentations

Background: The causes, clinical presentations and treatment outcomes of optic neuritis are distinct among different populations. Early diagnosis based on clinical presentations plays an important role in treating optic neuritis patients. Objective: The study aimed to determine clinical characteristics, treatment outcomes and predictive factors of treatment outcomes in optic neuritis patients with and without demyelinating disease. Methods: A retrospective descriptive study of optic neuritis patients carried out between January 2009 and December 2016 was done. Univariate analysis and multivariate logistic regression analysis were used to evaluate the predictive factors of treatment outcomes. Results: Among 150 patients with optic neuritis, 58 patients were diagnosed with Neuromyelitis Optica Spectrum Disease (NMOSD), 23 patients were diagnosed with Multiple Sclerosis (MS) and 69 patients were idiopathic. The age at presentation in the NMOSD group was significantly younger than the MS group and the idiopathic group. The female:male ratio was significantly lower in the idiopathic group than in the NMOSD group. The initial Best Corrected Visual Activity (BCVA) of 20/20-20/60 (p = 0.001) and the idiopathic group (p =0.030) was associated with good visual outcomes. Initial BCVA of < 20/200 (p = 0.009) and the NMOSD group (p < 0.001) was associated with poor visual outcomes. Conclusion: NMOSD is a more common cause of optic neuritis than MS in Thai population. Female patients with poor initial VA, poor response to steroids treatment, and presenting recurrent attacks are highly suspicious for NMOSD. Optic neuritis without associated demyelinating disease has a better visual outcome and lower recurrence rate.

Therapeutic efficacy of plasma exchange in NMO-IgG-positive patients with neuromyelitis optica

2007 ◽  
Vol 13 (1) ◽  
pp. 128-132 ◽  
Author(s):  
S Watanabe ◽  
I Nakashima ◽  
T Misu ◽  
I Miyazawa ◽  
Y Shiga ◽  
...  
Keyword(s):  
Optic Neuritis ◽  
Plasma Exchange ◽  
Neuromyelitis Optica ◽  
Therapeutic Efficacy ◽  
Demyelinating Disease ◽  
High Risk Group ◽  
Functional Improvement ◽  
High Dose ◽  
Humoral Immune

Neuromyelitis optica (NMO) is an inflammatory demyelinating disease of the central nervous system (CNS) with a poor prognosis in terms of the optic-spinal function. Recently, a serum autoantibody (NMO-IgG) binding to the blood–brain barrier region was detected exclusively in patients with NMO and its high risk group. We treated six NMO-IgG-positive patients (all female; age 21–67 years old, median 41; three with optic neuritis and three with myelitis) who were unresponsive to high-dose intravenous methylprednisolone (HIMP), with plasma exchange (PE) (three to five exchanges, 2–3 L each). Three of the patients(one with optic neuritis and two with myelitis) showed definite functional improvement following PE. The clinical improvement started to appear after one or two exchanges, while there was little or no improvement in the other three patients. Such quick clinical responses to PE suggest a pathogenetic role of humoral immune factors in NMO, although delayed responses to the corticosteroid therapy might have contributed to the therapeutic efficacy, in part. Further clinical and in vitro studies are needed to determine whether the removal of NMO-IgG is directly relevant to the therapeutic efficacy. PE may hasten the functional recovery from corticosteroid-resistant relapses in some NMO-IgG-positive patients with NMO.

scholarly journals Targeting Oxidative Stress for Treatment of Glaucoma and Optic Neuritis

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Atsuko Kimura ◽  
Kazuhiko Namekata ◽  
Xiaoli Guo ◽  
Takahiko Noro ◽  
Chikako Harada ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Optic Nerve ◽  
Optic Neuritis ◽  
Vision Loss ◽  
Demyelinating Disease ◽  
Ganglion Cells ◽  
Retinal Ganglion ◽  
Progressive Degeneration ◽  
Elevated Intraocular Pressure ◽  
The Central Nervous System

Glaucoma is a neurodegenerative disease of the eye and it is one of the leading causes of blindness. Glaucoma is characterized by progressive degeneration of retinal ganglion cells (RGCs) and their axons, namely, the optic nerve, usually associated with elevated intraocular pressure (IOP). Current glaucoma therapies target reduction of IOP, but since RGC death is the cause of irreversible vision loss, neuroprotection may be an effective strategy for glaucoma treatment. One of the risk factors for glaucoma is increased oxidative stress, and drugs with antioxidative properties including valproic acid and spermidine, as well as inhibition of apoptosis signal-regulating kinase 1, an enzyme that is involved in oxidative stress, have been reported to prevent glaucomatous retinal degeneration in mouse models of glaucoma. Optic neuritis is a demyelinating inflammation of the optic nerve that presents with visual impairment and it is commonly associated with multiple sclerosis, a chronic demyelinating disease of the central nervous system. Although steroids are commonly used for treatment of optic neuritis, reduction of oxidative stress by approaches such as gene therapy is effective in ameliorating optic nerve demyelination in preclinical studies. In this review, we discuss oxidative stress as a therapeutic target for glaucoma and optic neuritis.

scholarly journals Idiopathic Chiasmal Optic Neuritis in a Pediatric Patient

2021 ◽  
Vol 62 (12) ◽  
pp. 1679-1684
Author(s):  
Jae Pyeong Jeon ◽  
Donghun Lee ◽  
Jong Won Moon
Keyword(s):  
Visual Acuity ◽  
Optic Neuritis ◽  
Pediatric Patient ◽  
Demyelinating Disease ◽  
Late Onset ◽  
Systemic Disease ◽  
Brain Magnetic Resonance Imaging ◽  
Visual Disturbance ◽  
Systemic Steroid ◽  
The Right

Purpose: We report a case of idiopathic chiasmal optic neuritis in a pediatric patient.Case summary: A 13-year-old boy with no history of systemic disease was referred to our ophthalmology clinic because of visual disturbance in both eyes of 5 days in duration. The best-corrected visual acuity was 0.08 in the right eye and finger counting at 30 cm in the left eye; mild blurring of the disc margins (both eyes) was evident on fundus examination, as were temporal hemianopsia in the right eye and diffuse field loss in the left eye. Brain magnetic resonance imaging revealed focal nodular enhancement in the optic chiasm. Blood and cerebral fluid analysis yielded no evidence of infection or autoimmune disease. Therefore, we diagnosed isolated idiopathic chiasmal optic neuritis and commenced a systemic steroid. After 5 days, the visual acuity began to improve, and the field defect was almost eliminated (except for a small central scotoma) at 1 month. He has remained stable to the time of writing (4 months after treatment) and his visual acuity has normalized.Conclusions: Isolated idiopathic chiasmal optic neuritis developed in a pediatric patient and the visual function improved after steroid treatment. Although there was no evidence of systemic demyelinating disease, regular observation is scheduled given the possibility of late-onset disease.

Optic neuritis: Experience from a south Indian demyelinating disease registry

2012 ◽  
Vol 60 (5) ◽  
pp. 470 ◽  
Author(s):  
Lekha Pandit ◽  
Rammohan Rao ◽  
Rajesh Shetty ◽  
Hrishikesh Amin ◽  
Subrahmanya Bhat ◽  
...  
Keyword(s):  
Optic Neuritis ◽  
Demyelinating Disease ◽  
Disease Registry ◽  
South Indian

scholarly journals Low Contrast Visual Acuity Might Help to Detect Previous Optic Neuritis

2020 ◽  
Vol 11 ◽  
Author(s):  
Soo-Hyun Park ◽  
Choul Yong Park ◽  
Young Joo Shin ◽  
Kyoung Sook Jeong ◽  
Nam-Hee Kim
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Optic Neuritis ◽  
Roc Curve ◽  
Demyelinating Disease ◽  
Area Under The Curve ◽  
Youden Index ◽  
High Contrast ◽  
Roc Curve Analysis ◽  
Low Contrast

Optic neuritis (ON) has been considered to be an important factor in the diagnosis of multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD), making ON detection increasingly critical for early diagnosis. Furthermore, subclinical ONs presenting no distinct decrease in visual acuity can be missed. Low contrast visual acuity (LC-VA) is known to be able to capture visual loss not seen in conventional high-contrast visual acuity (HC-VA) in MS. Therefore, to increase the sensitivity of ON detection, we investigated the advantage of LC-VA over conventional HC-VA. One hundred and eight patients with demyelinating disease (35 MS, 73 NMOSD) with ON at least 3 months prior and 35 controls underwent neuro-ophthalmic evaluation, including best-corrected conventional high contrast visual acuity (HC-VA) and 2.5% and 1.25% low contrast visual acuity (LC-VA). Receiver operating characteristic (ROC) curve analysis and the area under the curve (AUC) of various visual functions were used to determine the most relevant visual function test for the detection of optic nerve involvement. Additionally, the optimal cutoff point was obtained from the Youden index (J-index) as the points with the best sensitivity-specificity balance. When distinguishing ON from non-ON, the area under the ROC curve (AUC) was highest for the 2.5% LC-VA (0.835, P &lt; 0.001; sensitivity 71.5%, specificity 88.6%), while it was 0.710 (P &lt; 0.001) for the HC-VA and 0.770 (P &lt; 0.001) for the 1.25% LC-VA. In discriminating between controls and ON, the AUC was also highest for the 2.5% LC-VA 0.754 (P &lt; 0.001; sensitivity 71.5%, specificity 78.5%), while it was 0.719 (P &lt; 0.001) for HC-VA and 0.688 (P &lt; 0.001) for 1.25% LC-VA. In eyes with a history of ON (n = 137), the HC-VA and 2.5% LC-VA were abnormal in 64.2 and 71.5%, respectively (P &lt; 0.001), with their combination detecting abnormalities in approximately 85.4% (P &lt; 0.001). The 2.5% LC-VA was superior to HC-VA in detecting ON when distinguishing ON from non-ON or control. The 2.5% LC-VA might be a useful, feasible, and rapid method to detect ON. Furthermore, combining 2.5% LC-VA with conventional HC-VA would be better for detecting optic nerve involvements.

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