Changes in the Incidence of Optic Neuritis before and after the Coronavirus Disease 2019 Outbreak

IF 9.5 1区医学 Q1 OPHTHALMOLOGY Ophthalmology Pub Date : 2024-09-13 DOI:10.1016/j.ophtha.2024.09.009

Jihei Sara Lee MD , Seung Won Lee MD, PhD , Nang Kyeong Lee MSc , Yong Joon Kim MD, PhD , Hyoung Won Bae MD, PhD , Chan Yun Kim MD, PhD

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Abstract

Purpose

To determine the risk of optic neuritis (ON) during nonpharmaceutical interventions (NPI), vaccination, and infection phases of the coronavirus disease 2019 (COVID-19) pandemic in comparison with levels before the outbreak in pediatric and adult populations in South Korea.

Design

A nationwide, population-based retrospective study.

Participants

South Korean individuals with a primary diagnosis of ON received between January 2017 and December 2022.

Methods

The Korean Health Insurance Review and Assessment database was queried for new diagnoses of ON between January 2017 and December 2022. Data were divided into 4 periods: before COVID-19 (2017–2019), NPI (2020), nationwide vaccination (2021), and nationwide infection (2022). The risk of ON development for each period was calculated and compared with levels before COVID-19, with 95% confidence intervals (CIs) reported.

Main Outcome Measures

Incidence rate ratio (IRR) of ON for each period.

Results

A total of 7216 patients (52.7% female patients) were included in the study, with patients receiving a diagnosis of ON as follows: 3770 patients before COVID-19 (2017–2019), 1193 patients during NPI, 1135 patients during vaccination, and 1118 patients during the infection phases. The annual incidence of ON during NPI (IRR, 0.92; 95% CI, 0.85–1.00; P = 0.043), vaccination (IRR, 0.88; 95% CI, 0.81–0.95; P = 0.001), and infection (IRR, 0.86; 95% CI, 0.80–0.93; P < 0.001) phases significantly decreased compared with levels before COVID-19 when adjusted for age and sex. The proportions of diagnosis with multiple sclerosis (MS), neuromyelitis optica (NMO), and acute disseminated encephalomyelitis (ADEM) among patients in whom ON developed increased significantly in 2021 in comparison with levels before COVID-19 (10.93% vs. 6.43%; P = 0.0002).

Conclusions

The risks of ON development during the NPI, vaccination, and infection phases of COVID-19 did not increase in comparison with levels before the outbreak in the general population. However, COVID-19 vaccination may be associated with increased risks of ON associated with diseases such as ADEM, MS, and NMO.

Financial Disclosure(s)

The author(s) have no proprietary or commercial interest in any materials discussed in this article.

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COVID-19 前后视神经炎发病率的变化：2017-2022年全国范围内的研究。

目的：确定韩国儿童和成人在冠状病毒病-19（COVID-19）的非药物干预（NPI）、疫苗接种和感染阶段发生视神经炎（ON）的风险，并与疫情爆发前的水平进行比较：设计：一项全国性、基于人群的回顾性研究：方法：韩国健康保险审查和评估数据库：方法：在韩国健康保险审查和评估数据库中查询 2017 年 1 月至 2022 年 12 月期间新诊断出的 ON 患者。数据分为4个时期：COVID-19前（2017-2019年）、NPI（2020年）、全国范围内接种（2021年）和全国范围内感染（2022年）。计算每个时期的ON发病风险，并与COVID-19前的水平进行比较，报告95%置信区间（CI）：结果：研究共纳入7216名患者（52.7%为女性），其中3770名患者在COVID-19之前（2017-2019年）被诊断为ON，1193名患者在NPI期间被诊断为ON，1135名患者在疫苗接种期间被诊断为ON，1118名患者在感染阶段被诊断为ON。在NPI（IRR为0.92（95% CI为0.85-1.00），P=0.043）、疫苗接种（IRR为0.88（95% CI为0.81-0.95），P=0.001）和感染（IRR为0.86（95% CI为0.80-0.93），PConclusions：与普通人群疫情爆发前的水平相比，COVID-19在NPI、疫苗接种和感染阶段的ON发病风险并未增加。然而，接种COVID-19疫苗可能会增加与ADEM、MS和NMOSD等疾病相关的ON风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ophthalmology 医学-眼科学

CiteScore

22.30

自引率

3.60%

发文量

412

审稿时长

18 days

期刊介绍： The journal Ophthalmology, from the American Academy of Ophthalmology, contributes to society by publishing research in clinical and basic science related to vision.It upholds excellence through unbiased peer-review, fostering innovation, promoting discovery, and encouraging lifelong learning.