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Ранняя потеря "Macular Ganglion Cell" в Leber Hereditary Optic Neurophy — биомаркер оптической совместимости для дифференцирования оптического неврита.

Фон/цели: Наследственная оптическая нейропатия Лебера (LHON) часто неправильно диагностируется на ранних этапах как идиопатический единичный оптический неуриит (SION) или многоклерозовый оптический неврал (MS-ON) из-за раннего возраста пациентов, потери субакутного зрения и нарушения центрального визуального поля. Цель этого ретроспективного исследования состояла в том, чтобы оценить изменения в перипиллярном RNFL и GCLT с течением времени у пациентов с ранним LHON, MS-ON и SION, с тем чтобы провести различие между наследственной нейропатией (LHON) и оптическим неуриитом (ON) на ранних стадиях

Совпадение в аннотации оригинала
Background/Objectives: Leber hereditary optic neuropathy (LHON) is often misdiagnosed in its early stages as idiopathic single isolated optic neuritis (SION) or multiple-sclerosis-associated optic neuritis (MS-ON) due to the young age of the patients, the subacute vision loss, and the central visual field defect. The aim of this retrospective study was to ev…

Optical coherence tomography angiography of peripapillary vessel density in non-arteritic anterior ischemic optic neuropathy and demyelinating optic neuritis.

BACKGROUND: In cases of optic disc edema or a pale optic disc, distinguishing an episode of optic neuritis (ON) from that of non-arteritic anterior ischemic optic neuropathy (NAION) during a clinical examination is challenging. Optical coherence tomography angiography (OCTA) can reveal differences in peripapillary vascular network structures and provide biomarkers for differential diagnosis. METHODS: A total of 23 eyes with NAION, 22 eyes with demyelinating ON (DON), and 27 eyes from healthy participants were imaged using OCTA to observe the radial peripapillary capillaries (RPCs). Optical co…

Acute changes in ganglion cell layer thickness in ischemic optic neuropathy compared to optic neuritis using optical coherence tomography.

AIM: To elucidate the changes of different ganglion cell layer (GCL) thinning patterns between the optic neuritis (ON) and non-arteritic anterior ischemic optic neuropathy (NAION). METHODS: A prospective, observational study was conducted to evaluate the timing of GCL changes between acute ON and NAION using optical coherence tomography. RESULTS: Thinning on optical coherence tomography in the NAION group occurs as early as 11d after symptomatic onset of vision loss and follows an altitudinal pattern. The mean superior-inferior GCL thickness difference in the NAION cohort was clinically sign…

Retinal nerve fiber layer thickness by Stratus and Cirrus OCT in retrobulbar optic neuritis and nonarteritic ischemic optic neuropathy.

PURPOSE: To compare retinal nerve fiber layer thickness (RNFLT) measurements by Stratus and Cirrus optical coherence tomography (OCT) and to evaluate agreement between the 2 instruments in retrobulbar optic neuritis (RON), nonarteritic ischemic optic neuropathy (NAION), and healthy controls. METHODS: A total of 89 eyes with RON, 92 with NAION (6 to 12 months after diagnosis of acute disease), and 159 control eyes were studied. Average RNFLT was measured by Stratus and Cirrus OCTs. Comparisons among groups were performed by analysis of variance. Agreement between the 2 instruments was assessed…

Radiomic analysis of the optic nerve at the first episode of acute optic neuritis: an indicator of optic nerve pathology and a predictor of visual recovery?

OBJECTIVE: Retinal nerve fiber layer thickness (RNFL) is a biomarker of neuroaxonal loss and index of visual function in multiple sclerosis (MS). We aimed to assess the correlation between radiomic features and RNFL, visual acuity (VA) at patients' presentation, visual outcome (VO), and clinical diagnosis. METHODS: We reviewed imaging and clinical data of 25 patients with a first episode of optic neuritis (ON) (14 females, 11 males; 5 bilateral ON; 7 left ON; 13 right ON). All patients underwent a complete ophthalmological assessment, including visual acuity and RNFL, neurological evaluation,…

Measurement of retinal nerve fiber layer thickness with a deep learning algorithm in ischemic optic neuropathy and optic neuritis.

This work aims at determining the ability of a deep learning (DL) algorithm to measure retinal nerve fiber layer (RNFL) thickness from optical coherence tomography (OCT) scans in anterior ischemic optic neuropathy (NAION) and demyelinating optic neuritis (ON). The training/validation dataset included 750 RNFL OCT B-scans. Performance of our algorithm was evaluated on 194 OCT B-scans from 70 healthy eyes, 82 scans from 28 NAION eyes, and 84 scans of 29 ON eyes. Results were compared to manual segmentation as a ground-truth and to RNFL calculations from the built-in instrument software. The Dice…

Leber's hereditary optic neuropathy (LHON)-related mitochondrial DNA sequence changes in italian patients presenting with sporadic bilateral optic neuritis.

Eighteen Italian patients presenting with sporadic, bilateral, simultaneous, or sequential optic neuritis (ON) were evaluated for 14 base changes in mitochondrial DNA (mtDNA) previously found associated with Leber's hereditary optic neuropathy (LHON), aiming to identify at a molecular level LHON cases with nontypical phenotypes. During a 36-month follow-up, 11 ON patients developed clinical or laboratory features allowing diagnosis of clinically definite multiple sclerosis (MS). None was positive for any of the "primary" LHON-associated mutations. However, single or multiple "secondary" LHON-a…

[Neutron spin tomography of the optic nerve in retrobulbar neuritis and optic nerve atrophy: demonstration of inflammation and demyelination].

Detection of inflammatory lesions of the optic nerve by magnetic resonance imaging requires a special imaging technique. In 3 patients with persisting visual loss due to retrobulbar neuritis we scanned the optic nerve with a short inversion recovery sequence. In each of the 3 patients magnetic resonance imaging revealed inflammatory lesions in the intracanalicular portion of the optic nerve. It is supposed that the unfavorable location of the lesions in the optic canal is responsible for the poor recovery of visual acuity. In another patient with a bilateral optic nerve atrophy demyelination o

Enhanced detection of optic neuritis with contrast-enhanced 3D FLAIR in orbital MRI.

PURPOSE: Diagnosing optic neuritis can be challenging, particularly in atypical cases where conventional MRI may be inconclusive. This study evaluates whether adding CE FS 3D FLAIR to standard orbital MRI improves diagnostic performance. METHODS: This retrospective single-center diagnostic accuracy study included 48 patients (mean age, 60 years ± 18; 30 women) clinically suspected of acute optic neuritis who underwent orbital MRI between September 2016 and July 2024. All underwent FS 2D T2WI, CE FS 3D T1WI, and CE FS 3D FLAIR. Definite optic neuritis was defined by combined clinical and parac…

Case Report: Progressive visual decline after optic neuritis associated with microcystic macular oedema.

A 39-year-old man was diagnosed with multiple sclerosis (MS) following unilateral optic neuritis (ON). His vision improved with corticosteroid treatment, but residual deficits remained (visual acuity at initial discharge: 0.7). Ocrelizumab was started, without any confirmed relapses or activity on magnetic resonance imaging (MRI) ever since. Nevertheless, his vision gradually deteriorated (0.3). Optical coherence tomography (OCT) detected microcystic macular oedema (MMO) at month 6, which showed clear progression over 5 years. MMO is rare, and longitudinal data on its evolution are scarce. In …

Magnetoencephalography biomarkers for assessing myelin content and neuronal function in acute optic neuritis.

The visual pathway is an important model system for remyelination and neuroprotection trials in multiple sclerosis, due to its accessibility and the availability of validated methods including visual evoked potential and optical coherence tomography. However, visual evoked potentials are sometimes undetectable and demonstrate limited reliability after acute optic neuritis. This study aims to investigate novel magnetoencephalography markers for assessing myelin content and neuronal dysfunction in the early phase of optic neuritis and describes their inter-run reproducibility ('over a single vis…

Diffusion tensor imaging parameters in the presence of optic neuritis in multiple sclerosis.

OBJECTIVE: This study examined how different diffusion tensor imaging (DTI) acquisition planes affect diffusion tensor indices in multiple sclerosis (MS) patients, stratified by optic neuritis (ON) history. MATERIALS AND METHODS: Thirty-seven relapsing-remitting MS patients were prospectively enrolled: 20 with a history of ON (MSwON) and 17 without (MSwoON). Each participant underwent DTI in both axial and coronal planes using a 1.5 Tesla MRI system. Optic nerve regions of interest were drawn independently for each plane, and 18 DTI-derived parameters were compared between groups using linear…

Current landscape of pediatric optic neuritis management in India: A clinical practice survey.

PURPOSE: To understand the practice patterns in the management of pediatric optic neuritis in India and detect the gaps in evaluation and management. METHODS: An online survey-based study questionnaire was shared among ophthalmologists in the last quarter of 2024. The questionnaire included questions pertaining to the clinical experience, evaluation, and management of optic neuritis in children. RESULTS: Seventy ophthalmologists across India participated in the survey. Of these, 45% had a formal neuro-ophthalmology training and 42% had more than 5 years of experience in managing pediatric op…

Clinical characteristics of optic neuritis following COVID-19 during Omicron outbreak in China.

PURPOSE: To investigate the clinical characteristics of early-onset optic neuritis (ON) following the corona virus disease 2019 (COVID-19) Omicron variant and explore the possible pathophysiological mechanisms. METHODS: This was a retrospective, observational study. All enrolled patients with ON following the COVID-19 Omicron variant were followed for at least 6 weeks to observe their clinical characteristics and prognostic factors and to analyze the factors influencing earlier or later occurrence of ON following the COVID-19 Omicron variant. RESULTS: A total of 47 eyes from 47 patients (22 …

Case report: Coexistence of optic neuritis and primary anti-PLA2R-positive membranous nephropathy.

BACKGROUND: Optic neuritis (ON) is an inflammatory optic neuropathy characterized by acute vision loss. Primary anti-PLA2R-positive membranous nephropathy, an autoimmune disease, has been reported to be related to neurological diseases. However, the co-occurrence of ON and primary membranous nephropathy (PMN) has not been reported. CASE PRESENTATION: A 57-year-old male presented with acute bilateral vision loss. Laboratory tests indicated proteinuria, hypoalbuminemia, hyperlipidemia, and a significantly increased level of anti-phospholipase A2 receptor antibody (PLA2RAb). Orbital MRI revealed…

Cost and availability of high-dose oral prednisone for management of optic neuritis.

OBJECTIVE: This study assesses the cost and availability of 1250 mg of oral prednisone for treatment of optic neuritis across pharmacies in Toronto. DESIGN: Prospective cross-sectional study PARTICIPANTS: Data collected from 70 pharmacies, across 4 regions in Toronto, Ontario, Canada METHODS: Data were collected from 70 pharmacies on cost and availability for 3- and 5-day courses of prednisone. Pharmacist hesitancy was assessed on the basis of the readiness of the pharmacist to dispense the required dose of medication. RESULTS: The average cost for a 3-day course of prednisone was $29.10 CAD…

Evaluation and comparison of large language models' responses to questions related optic neuritis.

OBJECTIVES: Large language models (LLMs) show promise as clinical consultation tools and may assist optic neuritis patients, though research on their performance in this area is limited. Our study aims to assess and compare the performance of four commonly used LLM-Chatbots-Claude-2, ChatGPT-3.5, ChatGPT-4.0, and Google Bard-in addressing questions related to optic neuritis. METHODS: We curated 24 optic neuritis-related questions and had three ophthalmologists rate the responses on two three-point scales for accuracy and comprehensiveness. We also assessed readability using four scales. The f…