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Side effects of glucocorticoid treatment. Experience of the Optic Neuritis Treatment Trial.

OBJECTIVE: To determine the incidence of side effects from short-term glucocorticoid therapy prescribed for treatment of optic neuritis in the Optic Neuritis Treatment Trial. DESIGN: Randomized, placebo-controlled, multicenter clinical trial. SETTING: Fifteen university- or hospital-based centers throughout the United States. PATIENTS: A total of 457 patients between the ages of 18 and 46 years with acute demyelinative optic neuritis were studied. INTERVENTIONS: (1) Intravenous methylprednisolone (250 mg every 6 hours) for 3 days while hospitalized followed by oral prednisone (1 mg/kg per …

The pattern electroretinogram: N95 amplitudes in normal subjects and optic neuritis patients.

Recent work has suggested that the N95 peak of the transient pattern electroretinogram (PERG) may be a more sensitive indicator of the late stages of retinal function prior to optic nerve activation than the P50 peak. In this report, we show that a new measure of N95 amplitude, based on digital filtering methods to identify a non-linear baseline before measurement, greatly reduced the amplitude variation in a population of 50 normal subjects when compared with two other plausible measures. We then used that new measure to follow the time course of N95 amplitudes in 12 optic neuritis patients. …

Pattern visually evoked cortical potential and magnetic resonance imaging in optic neuritis.

We studied the extent of optic nerve lesion with magnetic resonance imaging (MRI) in 24 patients with optic neuritis and compared it with visually evoked cortical potentials (VECP). Patients were divided into acute and chronic stage groups according to the duration of the disease from its onset. The short TI inversion recovery (STIR) mode of the MRI was selected for study. In the acute stage group, abnormally high signals of optic nerve on MRI were demonstrated in 11 of 12 eyes, and the amplitude and peak latency of pattern VECP were unrelated to the extent of the optic nerve lesion visualized…

Pattern electroretinograms in optic neuritis during the acute stage and after remission.

A total of 20 patients with unilateral acute optic neuritis were studied. Each patient had experienced the recent onset of a decrease in visual acuity, a relative afferent pupillary defect, a relative or absolute central scotoma and a colour-vision defect. The pattern-reversal electroretinogram (PERG) of each patient was analysed with regard to the amplitude of the positive and negative components. During the acute stage the amplitude of the positive component was reduced in all patients and that of the negative, in 18 of 20 cases. Parallel to clinical recovery, a steady increase was observed …

Tumor necrosis factor alpha gene polymorphism in multiple sclerosis and optic neuritis.

The NcoI tumor necrosis factor (TNF alpha) polymorphism was studied in relapsing/remitting multiple sclerosis and monosymptomatic optic neuritis. The frequency of the NcoI marker phenotypes did not differ between healthy controls and the two disease groups. No extra or missing DNA fragments were observed in the disease groups when compared with controls.

A long-term prospective study of optic neuritis: evaluation of risk factors.

Eighty-six patients with monosymptomatic optic neuritis of unknown cause were followed prospectively for a median period of 12.9 years. At onset, cerebrospinal fluid (CSF) pleocytosis was present in 46 patients (53%) but oligoclonal immunoglobulin in only 40 (47%) of the patients. The human leukocyte antigen (HLA)-DR2 was present in 45 (52%). Clinically definite multiple sclerosis (MS) was established in 33 patients. Actuarial analysis showed that the cumulative probability of developing MS within 15 years was 45%. Three risk factors were identified: low age and abnormal CSF at onset, and earl…

Myasthenia gravis and recurrent retrobulbar optic neuritis: an unusual combination of diseases.

A case is presented that illustrates the unusual concurrence of both myasthenia gravis and recurrent retrobulbar optic neuritis. The association of optic neuritis with myasthenia gravis might support the idea that there is a disorder of immune function in optic neuritis.

Acute optic neuritis: a prospective study of risk factors for multiple sclerosis.

Eighty two patients with isolated optic neuritis were studied prospectively to determine the frequency with which multiple sclerosis developed and the factors which increased its risk. Patients were followed for 6 to 264 months (mean, 57 months). Twenty six patients (32%) developed clinically definite or probable multiple sclerosis during the period of follow-up. Actuarial analysis predicted that 42% would develop multiple sclerosis by 7 years. Of those patients who developed multiple sclerosis, 92% had symptoms within 4 years of the first attack of optic neuritis. The highest incidence of mul…

Estimation of visual function after optic neuritis: a comparison of clinical tests.

A group of 53 patients who had suffered an attack of unilateral (n = 45) or bilateral (n = 8) optic neuritis more than six months before were subjected to a battery of tests to determine their spatial contrast sensitivity, visual field, and colour vision. The 106 eyes investigated were classified according to their clinical status and visual acuity at the time of the study into unaffected (n = 45), recovered (n = 33), and non-recovered (n = 28). At least one of the three tests gave an abnormal result in 67%, 88%, 100% of the three groups respectively. The results obtained with these three test…

Anti-myelin basic protein antibody in experimental allergic optic neuritis and encephalomyelitis.

We produced demyelinating optic neuritis and encephalomyelitis in juvenile strain 13 guinea pigs by sensitization with optic nerve myelin. Three distinct clinical courses were noted: a severe, acute optic neuritis associated with a rapidly fatal encephalomyelitis; a mild, chronic optic neuritis with a nonfatal encephalomyelitis; and an initially mild disease followed by an acute exacerbation of optic neuritis and fatal encephalomyelitis. Clinically mild disease was associated with elevated levels of anti-myelin basic protein antibody, while severe disease was associated with extremely low anti…

Effects of chronic demyelination on axonal transport in experimental allergic optic neuritis.

Axonal transport studies were undertaken to determine the effect of chronic demyelination on axonal function in experimental allergic optic neuritis in the guinea pig, an animal model for multiple sclerosis. Fast and slow components of axonal transport over the prelaminar, laminar, and retrolaminar portions of the optic nerve head and at the foci of demyelination in the retrobulbar optic nerve were evaluated by the autoradiographic grain-counting technique. At 6 hr there was a significant increase in grain counts over the demyelinated foci and in the regions proximal to the demyelination, incl…

Virus antibody levels in the cerebrospinal fluid from patients with optic neuritis.

Virus antibody levels were studied in the cerebrospinal fluid (CSF) of 58 patients with optic neuritis and 58 control patients with no indication of multiple sclerosis (MS) or infectious disorders of the central nervous system (CNS). The specimens were tested against three different structural components of measles virus with measles hemagglutination inhibition (HI), measles hemolysis inhibition (HLI) and gel precipitation (GP) tests. Measles antibodies occurred in 62 per cent of CSF specimens from patients with optic neuritis, and 21 per cent of the controls. In the specimens from patients wi…

The Importance of Optical Coherence Tomography in the Diagnosis of Atypical or Subclinical Optic Neuritis: A Case Series Study.

Background: Optic neuritis (ON) is an inflammatory condition of the optic nerve. ON is associated with development of demyelinating diseases of the central nervous system (CNS). CNS lesions visualized by magnetic resonance imaging (MRI) and the finding of oligoclonal IgG bands (OB) in the cerebrospinal fluid (CSF) are used to stratify the risk of MS after a "first" episode of ON. However, the diagnosis of ON in absence of typical clinical manifestations can be challenging. Methods and Materials: Here we present three cases with changes in the optic nerve and ganglion cell layer in the retina o…

The Role of Optical Coherence Tomography Criteria and Machine Learning in Multiple Sclerosis and Optic Neuritis Diagnosis.

BACKGROUND AND OBJECTIVES: Recent studies have suggested that intereye differences (IEDs) in peripapillary retinal nerve fiber layer (pRNFL) or ganglion cell + inner plexiform (GCIPL) thickness by spectral domain optical coherence tomography (SD-OCT) may identify people with a history of unilateral optic neuritis (ON). However, this requires further validation. Machine learning classification may be useful for validating thresholds for OCT IEDs and for examining added utility for visual function tests, such as low-contrast letter acuity (LCLA), in the diagnosis of people with multiple sclerosi…

Artificial neural network techniques to improve the ability of optical coherence tomography to detect optic neuritis.

PURPOSE: To analyze the ability of Spectralis optical coherence tomography (OCT) to detect multiple sclerosis (MS) and to distinguish MS eyes with antecedent optic neuritis (ON). To analyze the capability of artificial neural network (ANN) techniques to improve the diagnostic precision. METHODS: MS patients and controls were enrolled (n = 217). OCT was used to determine the 768 retinal nerve fiber layer thicknesses. Sensitivity and specificity were evaluated to test the ability of OCT to discriminate between MS and healthy eyes, and between MS with and without antecedent ON using ANN. RESULT…

Nasal-Predominant Ganglion Cell-Inner Plexiform Layer Thinning Distinguishes Early-Stage Leber Hereditary Optic Neuropathy From Acute Optic Neuritis.

BACKGROUND: To compare acute-phase macular ganglion cell-inner plexiform layer (GCIPL) thickness on optical coherence tomography (OCT) between Leber hereditary optic neuropathy (LHON) and optic neuritis (ON), and to evaluate the diagnostic performance of nasal GCIPL thickness. METHODS: In this retrospective single-centre study, OCT (CIRRUS HD-OCT; Carl Zeiss Meditec, Dublin) acquired within 45 days of symptom onset was analysed. Sectoral GCIPL thickness was compared between LHON and ON-including double-seronegative (DN-ON), aquaporin-4 antibody-positive (AQP4-ON) and myelin oligodendrocyte gl…

Proteomic Profiling of Optic Nerves From SMOX-Deficient Mice Identifies Regulators of Neuroinflammation and Axonal Damage in Optic Neuritis.

PURPOSE: Visual dysfunction due to optic neuritis (ON) is an early clinical manifestation of multiple sclerosis (MS). ON is characterized by inflammation of the optic nerve, demyelination, axonal damage, and retinal ganglion cell (RGC) loss. Previously, we showed that spermine oxidase (SMOX), a polyamine catabolizing enzyme, modulates visual function in an experimental model of ON. Using proteomic analysis, the present study aimed to identify SMOX-regulated molecular pathways involved in ON-associated visual dysfunction. METHODS: Experimental autoimmune encephalomyelitis (EAE) was induced in …

Дифференциация острой фазы AQP4-IgG+ оптического неврата от раковых заболеваний CNS с использованием оптического анализа кровотока мозга нервной системы.

Ранняя диагностика оптического неурита (ОН), связанного с аквапорином-4 иммуноглобулином-G (AQP4-IgG), миэлином олигодендроцитом гликопротеином иммуноглобулином-G (MOG-IgG), или множественным склерозом (MS), является сложной задачей из-за инвазивных и трудоемких тестов. Мы изучили вопрос о том, могут ли офтальмологические оценки, включая лазерную спеклированную трафографию (LSFG) и оптическо-согласованную томографию (OCT), быть полезными для проведения различий между этими заболеваниями на начальном этапе. Это ретроспективное исследование охватывало 10 пациентов AQP4-IgG+ON, 20 пациентов MOG-I

Совпадение в аннотации оригинала
Early diagnosis of optic neuritis (ON) associated with aquaporin-4 immunoglobulin-G (AQP4-IgG), myelin oligodendrocyte glycoprotein immunoglobulin-G (MOG-IgG), or multiple sclerosis (MS) is challenging due to invasive and time-consuming tests. We investigated whether ophthalmologic assessments, including laser speckle flowgraphy (LSFG) and optical coherence …