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Etiologies of Acute Optic Neuritis in Thailand: An Observational Study of 171 Patients

Authors
  • Vanikieti, Kavin1
  • Janyaprasert, Pavarut1
  • Lueangram, Sirin1
  • Nimworaphan, Jirat1
  • Rattanathamsakul, Natthapon1
  • Tiraset, Nanida1
  • Chokthaweesak, Wimonwan1
  • Samipak, Narong1
  • Padungkiatsagul, Tanyatuth1
  • Preechawat, Pisit1
  • Poonyathalang, Anuchit1
  • Pulkes, Teeratorn1
  • Tunlayadechanont, Supoch1
  • Siriyotha, Sukanya1
  • Jindahra, Panitha1
  • 1 Mahidol University, Bangkok, 10400 , (Thailand)
Type
Published Article
Journal
Clinical Ophthalmology (Auckland, N.Z.)
Publisher
Dove
Publication Date
Sep 30, 2020
Volume
14
Pages
2935–2942
Identifiers
DOI: 10.2147/OPTH.S271820
PMID: 33061279
PMCID: PMC7533266
Source
PubMed Central
Keywords
License
Green

Abstract

Purpose To analyze the demographic patterns, clinical characteristics and etiologies of acute optic neuritis (ON). Methods This retrospective observational study included patients with acute ON who presented to a university hospital in Bangkok, Thailand, between January 2010 and March 2020. The demographic details, clinical characteristics and etiologies of acute ON were evaluated. Results A total of 171 patients were included in the study (78.4% [n=134] female; mean age 45 years [standard deviation 15.4 years]; 32.2% [n=55] bilateral involvement). The most common type of acute ON was idiopathic (51.5%), followed by neuromyelitis optica spectrum disorder (NMOSD, 30.9%), other autoimmune disorders (9.9%), myelin oligodendrocyte glycoprotein antibody-associated disorder (MOGAD, 5.3%), multiple sclerosis (MS, 1.8%), and postinfection (0.6%). In the other autoimmune disorders group, 2 patients developed systemic lupus erythematosus (1.2%), 2 Sjogren’s syndrome (1.2%), 1 RA (0.6%), 1 anti-NMDAR (0.6%), 3 anti-Jo1 (1.8%), 2 c-ANCA (1.2%), 1 anti-centromere (0.6%), and 5 nonspecific autoimmune disorders (2.9%). In the idiopathic group, 38.6% developed single isolated ON, 1.8% relapsing isolated ON and 11.1% chronic relapsing inflammatory optic neuropathy. Conclusion The most common form of acute ON in this study, similar to other Asian countries, was idiopathic. Idiopathic-ON shared some phenotypes with NMOSD and MOGAD. We also reported patients with anti-NMDAR, anti-Jo1, c-ANCA and anti-centromere disorders. Improvements in antibody detection have widened the range of possible etiologies of acute ON. The study highlighted the important role of antibodies in creating effective treatments in the future.

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