Serial Analyses of Clinical Spectra and Outcomes in Chinese Women with Pregnancy-induced Optic Neuritis

Overview

Journal Front Med (Lausanne)

Specialty General Medicine

Date 2022 Dec 12

PMID 36507533

Authors

Wenhao Bai

Mingming Sun

Honglu Song

Hongen Li

Xintong Xu

Xiyun Chen

Yixuan Zhao

Biyue Chen

Sheng Yao

Quangang Xu

Shihui Wei

Huanfen Zhou

Shengyuan Yu

Affiliations

Soon will be listed here.

Abstract

Objective: This study aimed to investigate the clinical spectra and outcomes in pregnancy-related optic neuritis (ON).

Methods: We analyzed the clinical subtype and prognosis of women with pregnancy-related ON in the neuro-ophthalmology department of the First Medical Center at the Chinese PLA General Hospital from January 2014 to December 2019.

Results: A total of 54 patients, including 21 (38.9%) with idiopathic ON (ION), 27 (50.0%) with aquaporin-4 (AQP4)-ON, and 6 (11.6%) with myelin oligodendrocyte glycoprotein (MOG)-ON, who experienced 58 informative pregnancies and 67 episodes of pregnancy-related ON were assessed. Among the ON attacks, there were 11 (16.4%) during pregnancy and 56 (83.6%) within 1 year postpartum (PP1) or after abortion, including 33 (49.3%) in the first trimester. In total, 14 (25.9%) patients with ON onset before pregnancy had a higher relapse rate during PP1 than within 1 year before pregnancy ( = 0.021), and 24 (85.7%) eyes with ION and nine (100%) with MOG-ON had significantly better visual outcomes (p ≥ 0.5) than those with AQP4-ON (14, 35%) ( < 0.001 and < 0.001, respectively). Two AQP4-ON patients had premature birth and low baby weight, respectively. There were no birth defects or stillbirths.

Conclusion: The significantly increased relapse rate and numerous cases of ON after pregnancy suggest that delivery adversely affects the course of ON.

Citing Articles

Case report: Satralizumab as an adjunctive therapy for AQP-4 antibody and MOG antibody dual-negative optic neuritis in a third-trimester pregnancy case.

Sun C, Liu Z Front Med (Lausanne). 2024; 11:1514687.

PMID: 39687907 PMC: 11648988. DOI: 10.3389/fmed.2024.1514687.

A Narrative Review on Neuro-Ophthalmological Manifestations That May Occur during Pregnancy.

Anton N, Bogdanici C, Branisteanu D, Armeanu T, Ilie O, Doroftei B Life (Basel). 2024; 14(4).

PMID: 38672703 PMC: 11051142. DOI: 10.3390/life14040431.

Lactational optic neuritis - A case series with review of the literature.

Chaudhary S, Gandhi A, Das S, Jayasri K, Maheshkumar S, Kowsalya A Indian J Ophthalmol. 2024; 72(11):1593-1597.

PMID: 38622848 PMC: 11668224. DOI: 10.4103/IJO.IJO_2133_23.

References

Milo R, Miller A . Revised diagnostic criteria of multiple sclerosis. Autoimmun Rev. 2014; 13(4-5):518-24. DOI: 10.1016/j.autrev.2014.01.012. View

Jurewicz A, Selmaj K . Relapse of neuromyelitis optica during pregnancy--treatment options and literature review. Clin Neurol Neurosurg. 2015; 130:159-61. DOI: 10.1016/j.clineuro.2014.12.023. View

Huang Y, Wang Y, Zhou Y, Huang Q, Sun X, Chen C . Pregnancy in neuromyelitis optica spectrum disorder: A multicenter study from South China. J Neurol Sci. 2016; 372:152-156. DOI: 10.1016/j.jns.2016.11.054. View

Toosy A, Mason D, Miller D . Optic neuritis. Lancet Neurol. 2013; 13(1):83-99. DOI: 10.1016/S1474-4422(13)70259-X. View

Zhou H, Xu Q, Zhao S, Wang W, Wang J, Chen Z . Distinct clinical characteristics of atypical optic neuritis with seronegative aquaporin-4 antibody among Chinese patients. Br J Ophthalmol. 2017; 101(12):1720-1724. DOI: 10.1136/bjophthalmol-2017-310157. View

Sand I . Classification, diagnosis, and differential diagnosis of multiple sclerosis. Curr Opin Neurol. 2015; 28(3):193-205. DOI: 10.1097/WCO.0000000000000206. View

Shi B, Zhao M, Geng T, Qiao L, Zhao Y, Zhao X . Effectiveness and safety of immunosuppressive therapy in neuromyelitis optica spectrum disorder during pregnancy. J Neurol Sci. 2017; 377:72-76. DOI: 10.1016/j.jns.2017.03.051. View

Robinson D, Klein S . Pregnancy and pregnancy-associated hormones alter immune responses and disease pathogenesis. Horm Behav. 2012; 62(3):263-71. PMC: 3376705. DOI: 10.1016/j.yhbeh.2012.02.023. View

Zhou H, Zhao S, Yin D, Chen X, Xu Q, Chen T . Optic neuritis: a 5-year follow-up study of Chinese patients based on aquaporin-4 antibody status and ages. J Neurol. 2016; 263(7):1382-9. DOI: 10.1007/s00415-016-8155-7. View

10.

Ramanathan S, Reddel S, Henderson A, Parratt J, Barnett M, Gatt P . Antibodies to myelin oligodendrocyte glycoprotein in bilateral and recurrent optic neuritis. Neurol Neuroimmunol Neuroinflamm. 2014; 1(4):e40. PMC: 4215392. DOI: 10.1212/NXI.0000000000000040. View

11.

Ramanathan S, Mohammad S, Tantsis E, Nguyen T, Merheb V, Fung V . Clinical course, therapeutic responses and outcomes in relapsing MOG antibody-associated demyelination. J Neurol Neurosurg Psychiatry. 2017; 89(2):127-137. PMC: 5800335. DOI: 10.1136/jnnp-2017-316880. View

12.

Asgari N, Henriksen T, Petersen T, Lillevang S, Weinshenker B . Pregnancy outcomes in a woman with neuromyelitis optica. Neurology. 2014; 83(17):1576-7. DOI: 10.1212/WNL.0000000000000911. View

13.

Fragoso Y, Boggild M, Macias-Islas M, Carra A, Schaerer K, Aguayo A . The effects of long-term exposure to disease-modifying drugs during pregnancy in multiple sclerosis. Clin Neurol Neurosurg. 2012; 115(2):154-9. DOI: 10.1016/j.clineuro.2012.04.024. View

14.

Storoni M, Davagnanam I, Radon M, Siddiqui A, Plant G . Distinguishing optic neuritis in neuromyelitis optica spectrum disease from multiple sclerosis: a novel magnetic resonance imaging scoring system. J Neuroophthalmol. 2013; 33(2):123-7. DOI: 10.1097/WNO.0b013e318283c3ed. View

15.

Fragoso Y, Adoni T, Bichuetti D, Bidin Brooks J, Brito Ferreira M, Oliveira E . Neuromyelitis optica and pregnancy. J Neurol. 2013; 260(10):2614-9. DOI: 10.1007/s00415-013-7031-y. View

16.

Wingerchuk D, Banwell B, Bennett J, Cabre P, Carroll W, Chitnis T . International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology. 2015; 85(2):177-89. PMC: 4515040. DOI: 10.1212/WNL.0000000000001729. View

17.

Liu T, Crow R . Bilateral idiopathic optic neuritis in pregnancy. Semin Ophthalmol. 2013; 28(1):46-9. DOI: 10.3109/08820538.2012.735333. View

18.

Liu H, Zhou H, Wang J, Sun M, Teng D, Song H . The prevalence and prognostic value of myelin oligodendrocyte glycoprotein antibody in adult optic neuritis. J Neurol Sci. 2018; 396:225-231. DOI: 10.1016/j.jns.2018.11.029. View

19.

Cornelio D, Braga R, Rosa M, Ayub A . Devic's neuromyelitis optica and pregnancy: distinction from multiple sclerosis is essential. Arch Gynecol Obstet. 2009; 280(3):475-7. DOI: 10.1007/s00404-008-0918-7. View

20.

Ramanathan S, Dale R, Brilot F . Anti-MOG antibody: The history, clinical phenotype, and pathogenicity of a serum biomarker for demyelination. Autoimmun Rev. 2015; 15(4):307-24. DOI: 10.1016/j.autrev.2015.12.004. View