The Primary Systemic Vasculitis Associated Optic Neuritis: a Retrospective Analysis in a Single Center over 10 Years

Overview

Journal Int Ophthalmol

Specialty Ophthalmology

Date 2024 Sep 23

PMID 39312014

Authors

Simeng Tang

Hang Zhou

Rui Li

Yu Wang

Hongyang Li

Yanli Hou

Affiliations

Soon will be listed here.

Abstract

Objectives: To investigate the clinical and image characteristics of primary systemic vasculitis-associated optic neuritis patients.

Methods: This is a retrospective study. The patients clinically diagnosed with primary system vasculitis-induced optic neuritis were recruited from March 2013 to December 2023. All cases received orbital magnetic resonance imaging scans were analyzed. The ocular findings, systemic manifestations, laboratory data and prognosis were reviewed retrospectively. In addition, the related literature was reviewed.

Results: Fourteen patients (21 eyes), including 10 men and 4 women, were enrolled in this study. The ages ranged from 30 to 86 years in this cohort. Orbits MRI detects the enlargement and/or enhancement of the optic nerve. Cases 1-5 reported a confirmed diagnosis of Takayasu's arteritis, and cases 6-8 had giant cell arteritis. Cases 9-13 were antineutrophil cytoplasmic antibody-associated vasculitis. Case 14 was Cogan's syndrome. Mult organs and tissues, such as the kidneys, heart, paranasal sinuses, meninges, and respiratory system, were involved. In all of the 14 involved patients, the disease onset was either during the fall or winter season. There were no or only slight improvements in visual activity after conventional therapies.

Conclusions: The autoantibodies' attack on the optic nerve, ischemic damage, or destruction of the blood-brain barrier may be the potential pathogenesis of vasculitis-associated optic neuritis. Even with prompt and aggressive clinical interventions, the prognosis remains unsatisfactory.

References

Suppiah R, Robson J, Grayson P, Ponte C, Craven A, Khalid S . 2022 American College of Rheumatology/European Alliance of Associations for Rheumatology classification criteria for microscopic polyangiitis. Ann Rheum Dis. 2022; 81(3):321-326. DOI: 10.1136/annrheumdis-2021-221796. View

Hayreh S, Podhajsky P, Zimmerman B . Ocular manifestations of giant cell arteritis. Am J Ophthalmol. 1998; 125(4):509-20. DOI: 10.1016/s0002-9394(99)80192-5. View

Suga K, Nomoto Y, Sudo A, Isogai J, Suzuki Y, Kagami S . Granulomatosis with polyangiitis complicated with refractory optic neuritis and maxillary osteomyelitis. Mod Rheumatol Case Rep. 2020; 4(1):79-83. DOI: 10.1080/24725625.2019.1638050. View

Belden C, Hamed L, Mancuso A . Bilateral isolated retrobulbar optic neuropathy in limited Wegener's granulomatosis. J Clin Neuroophthalmol. 1993; 13(2):119-23. View

Yamamoto K, Takase Y, Nogaki H, Fukusako T, Morimatus M . [A case of Cogan's syndrome associated with multiple cranial neuropathy]. Rinsho Shinkeigaku. 1990; 30(6):639-42. View

Papaliodis G . Ophthalmologic manifestations of systemic vasculitis. Curr Opin Ophthalmol. 2017; 28(6):613-616. DOI: 10.1097/ICU.0000000000000422. View

Huchzermeyer C, Mardin C, Holbach L, Zwerina J, Schett G, Rech J . Successful remission induction with a combination therapy of rituximab, cyclophosphamide, and steroids in a patient with refractory optic neuritis in Wegener's granulomatosis. Clin Rheumatol. 2010; 32 Suppl 1:S97-101. DOI: 10.1007/s10067-010-1561-9. View

Jennette J, Falk R, Bacon P, Basu N, Cid M, Ferrario F . 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum. 2012; 65(1):1-11. DOI: 10.1002/art.37715. View

Maikap D, Pradhan A, Padhan P . A rare case of atypical Cogan's syndrome presenting as encephalitis. Mod Rheumatol Case Rep. 2021; 6(2):305-308. DOI: 10.1093/mrcr/rxab055. View

10.

Gu J, Zhou S, Ding R, Aizezi W, Jiang A, Chen J . Necrotizing scleritis and peripheral ulcerative keratitis associated with Wegener's granulomatosis. Ophthalmol Ther. 2014; 2(2):99-111. PMC: 4108142. DOI: 10.1007/s40123-013-0016-1. View

11.

Cantini F, Niccoli L, Salvarani C, Padula A, Olivieri I . Treatment of longstanding active giant cell arteritis with infliximab: report of four cases. Arthritis Rheum. 2002; 44(12):2933-5. DOI: 10.1002/1529-0131(200112)44:12<2933::aid-art482>3.0.co;2-y. View

12.

Lee A, Eggenberger E, Kaufman D, Manrique C . Optic nerve enhancement on magnetic resonance imaging in arteritic ischemic optic neuropathy. J Neuroophthalmol. 1999; 19(4):235-7. View

13.

Grayson P, Ponte C, Suppiah R, Robson J, Gribbons K, Judge A . 2022 American College of Rheumatology/EULAR classification criteria for Takayasu arteritis. Ann Rheum Dis. 2022; 81(12):1654-1660. DOI: 10.1136/ard-2022-223482. View

14.

BICKNELL J, Holland J . Neurologic manifestations of Cogan syndrome. Neurology. 1978; 28(3):278-81. DOI: 10.1212/wnl.28.3.278. View

15.

Salvi F, Mascalchi M, Pasini E, Bartolomei I, Fini N, Marliani F . p-ANCA pachymeningitis presenting with isolated "optic neuropathy". Neurol Sci. 2010; 31(5):639-41. DOI: 10.1007/s10072-010-0283-8. View

16.

Harada T, Ohashi T, Harada C, Yoshida K, Maguchi S, Moriwaka F . A case of bilateral optic neuropathy and recurrent transverse myelopathy associated with perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA). J Neuroophthalmol. 1998; 17(4):254-6. View

17.

Robson J, Grayson P, Ponte C, Suppiah R, Craven A, Judge A . 2022 American College of Rheumatology/European Alliance of Associations for Rheumatology classification criteria for granulomatosis with polyangiitis. Ann Rheum Dis. 2022; 81(3):315-320. DOI: 10.1136/annrheumdis-2021-221795. View

18.

Singh A, Kermani T, Crowson C, Weyand C, Matteson E, Warrington K . Visual manifestations in giant cell arteritis: trend over 5 decades in a population-based cohort. J Rheumatol. 2014; 42(2):309-15. PMC: 4367485. DOI: 10.3899/jrheum.140188. View

19.

Moubayed S, Black D . Optic neuritis as an initial presentation of Wegener's granulomatosis. Can J Ophthalmol. 2010; 44(6):e59. DOI: 10.3129/i09-145. View

20.

Gluth M, Baratz K, Matteson E, Driscoll C . Cogan syndrome: a retrospective review of 60 patients throughout a half century. Mayo Clin Proc. 2006; 81(4):483-8. DOI: 10.4065/81.4.483. View