Philipp Klyscz, Susanna Asseyer, Ricardo Alonso, Charlotte Bereuter, Omer Bialer, Atira Bick, Sara Carta, John J. Chen, Leila Cohen, Yamit Cohen-Tayar, Edgar Carnero Contentti, Russell C. Dale, Eoin P. Flanagan, Jonathan A. Gernert, Julian Haas, Joachim Havla, Christoph Heesen, Mark Hellmann, Netta Levin, Pablo Lopez, Itay Lotan, Maria Belen Luis, Sara Mariotto, Christina Mayer, Alvaro Jose Mejia Vergara, Cassandra Ocampo, Susana Ochoa, Frederike C. Oertel, Maja Olszewska, José Luis Peralta Uribe, Jaume Sastre-Garriga, Dario Scocco, Sudarshini Ramanathan, Natthapon Rattanathamsakul, Fu-Dong Shi, Jemal Shifa, Ilya Simantov, Sasitorn Siritho, Alon Tiosano, Nanthaya Tisavipat, Isabel Torres, Adi Vaknin Dembinsky, Angela Vidal-Jordana, Adi Wilf-Yarkoni, Ti Wu, Sol Zamir, Luis Alfonso Zarco, Hanna G. Zimmermann, Axel Petzold, Friedemann Paul, Hadas Stiebel-Kalish
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引用次数: 0
Abstract
Objective
The first international consensus criteria for optic neuritis (ICON) were published in 2022. We applied these criteria to a prospective, global observational study of acute optic neuritis (ON).
Methods
We included 160 patients with a first-ever acute ON suggestive of a demyelinating CNS disease from the Acute Optic Neuritis Network (ACON). We applied the 2022 ICON to all participants and subsequently adjusted the ICON by replacing a missing relative afferent pupillary defect (RAPD) or dyschromatopsia if magnetic resonance imaging pathology of the optical nerve plus optical coherence tomography abnormalities or certain biomarkers are present.
Results
According to the 2022 ICON, 80 (50%) patients were classified as definite ON, 12 (7%) patients were classified as possible ON, and 68 (43%) as not ON (NON). The main reasons for classification as NON were absent RAPD (52 patients, 76%) or dyschromatopsia (49 patients, 72%). Distribution of underlying ON etiologies was as follows: 78 (49%) patients had a single isolated ON, 41 (26%) patients were diagnosed with multiple sclerosis, 25 (16%) patients with myelin oligodendrocyte glycoprotein antibody-associated disease, and 15 (9%) with neuromyelitis optica spectrum disorder. The application of the adjusted ON criteria yielded a higher proportion of patients classified as ON (126 patients, 79%).
Interpretation
According to the 2022 ICON, almost half of the included patients in ACON did not fulfill the requirements for classification of definite or possible ON, particularly due to missing RAPD and dyschromatopsia. Thorough RAPD examination and formal color vision testing are critical to the application of the 2022 ICON.
期刊介绍:
Annals of Clinical and Translational Neurology is a peer-reviewed journal for rapid dissemination of high-quality research related to all areas of neurology. The journal publishes original research and scholarly reviews focused on the mechanisms and treatments of diseases of the nervous system; high-impact topics in neurologic education; and other topics of interest to the clinical neuroscience community.