Clinical characteristics, therapeutic outcomes of isolated atypical optic neuritis in China.

BACKGROUND/AIM: The causes of atypical optic neuritis are different from typical demyelinating optic neuritis. It may exist as an isolated entity or may be part of a systemic process. Our aim was to determine the clinical characteristics, and therapeutic outcomes of isolated atypical optic neuritis in China.

METHODS

Inclusion criteria for isolated atypical optic neuritis required fulfillment of at least one of (1)-(3) and both (4), and (5): (1) Visual loss progressing for >2 weeks since onset, (2) No visual recovery over 3 weeks after onset, (3) Worsening of vision over one line of acuity after withdrawal of corticosteroids, (4) No diagnosis of a defined collagen vascular disease or neurological autoimmune disease at onset, and (5) Neuro-ophthalmic follow-up for at least 12 months.

RESULTS

20 cases fulfilled isolated atypical optic neuritis inclusion criteria. 10 cases (50%) were anti-aquaporin-4 antibody positive. 11 of 20 cases (55%) with flare of optic neuritis at the withdrawal of corticosteroids responded poorly to reinitiation of corticosteroid therapy. At the end of follow-up (median 41 month), vision in 60% of involved eyes (18/30 eyes) was still 20/200 or worse.

CONCLUSIONS

In China, isolated atypical optic neuritis has a high incidence of anti-aquaporin-4 antibody and is resistant to corticosteroid therapy.