Application of the international criteria for optic neuritis in the Acute Optic Neuritis Network.
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Klyscz Philipp, Asseyer Susanna, Alonso Ricardo, Bereuter Charlotte, Bialer Omer, Bick Atira, Carta Sara, Chen John J, Cohen Leila, Cohen-Tayar Yamit, Carnero Contentti Edgar, Dale Russell C, Flanagan Eoin P, Gernert Jonathan A, Haas Julian, Havla Joachim, Heesen Christoph, Hellmann Mark, Levin Netta, Lopez Pablo, Lotan Itay, Luis Maria Belen, Mariotto Sara, Mayer Christina, Vergara Alvaro Jose Mejia, Ocampo Cassandra, Ochoa Susana, Oertel Frederike C, Olszewska Maja, Uribe José Luis Peralta, Sastre-Garriga Jaume, Scocco Dario, Ramanathan Sudarshini, Rattanathamsakul Natthapon, Shi Fu-Dong, Shifa Jemal, Simantov Ilya, Siritho Sasitorn, Tiosano Alon, Tisavipat Nanthaya, Torres Isabel, Dembinsky Adi Vaknin, Vidal-Jordana Angela, Wilf-Yarkoni Adi, Wu Ti, Zamir Sol, Zarco Luis Alfonso, Zimmermann Hanna G, Petzold Axel, Paul Friedemann, Stiebel-Kalish Hadas
Аннотация
METHODS: We included 160 patients with a first-ever acute ON suggestive of a demyelinating CNS disease from the Acute Optic Neuritis Network (ACON). We applied the 2022 ICON to all participants and subsequently adjusted the ICON by replacing a missing relative afferent pupillary defect (RAPD) or dyschromatopsia if magnetic resonance imaging pathology of the optical nerve plus optical coherence tomography abnormalities or certain biomarkers are present.
RESULTS: According to the 2022 ICON, 80 (50%) patients were classified as definite ON, 12 (7%) patients were classified as possible ON, and 68 (43%) as not ON (NON). The main reasons for classification as NON were absent RAPD (52 patients, 76%) or dyschromatopsia (49 patients, 72%). Distribution of underlying ON etiologies was as follows: 78 (49%) patients had a single isolated ON, 41 (26%) patients were diagnosed with multiple sclerosis, 25 (16%) patients with myelin oligodendrocyte glycoprotein antibody-associated disease, and 15 (9%) with neuromyelitis optica spectrum disorder. The application of the adjusted ON criteria yielded a higher proportion of patients classified as ON (126 patients, 79%).
INTERPRETATION: According to the 2022 ICON, almost half of the included patients in ACON did not fulfill the requirements for classification of definite or possible ON, particularly due to missing RAPD and dyschromatopsia. Thorough RAPD examination and formal color vision testing are critical to the application of the 2022 ICON.