Clinical features and visual prognosis of very late-onset neuromyelitis optica spectrum disorder–related optic neuritis.

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    • Subject Terms:
      NEUROMYELITIS optica; OPTIC neuritis; ANTINUCLEAR factors; LOGISTIC regression analysis
    • Abstract:
      Background: Very late-onset neuromyelitis optica spectrum disorder–related optic neuritis is limited to a few case reports. Objective: To investigate the clinical features and visual prognosis of very late-onset neuromyelitis optica spectrum disorder–related optic neuritis. Methods: This study evaluated 22 patients with first-onset optic neuritis and fulfilled the 2015 diagnosis criteria for neuromyelitis optica spectrum disorders. Results: The mean age at optic neuritis onset was 73.91 ± 4.71 (range: 70–82) years with a female predominance (81.8%; ratio: 4.5:1). Antinuclear antibody seropositivity and seronegativity were identified in 12 (55.5%) and 10 (45.5%) patients, respectively. Severe visual loss persisted in 19 (19/42, 45.3%) eyes at the last follow-up. Although patients with antinuclear antibody seropositivity had a significantly higher frequency of attacks (P = 0.015), but they had a longer median time to reach severe visual loss (37 vs. 26 months; log-rank test, P = 0.023). Multivariate logistic regression analysis revealed antinuclear antibody seropositivity (hazard ratio = 4.849, 95% confidence interval: 1.309–17.965, P = 0.018) as a good predictor of visual acuity improvement. Conclusion: Patients with very late-onset neuromyelitis optica spectrum disorder–related optic neuritis may develop severe optic neuritis, and those with antinuclear antibody seronegativity have a similar clinical presentation but worse outcome than those with seropositivity. [ABSTRACT FROM AUTHOR]
    • Abstract:
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