Purpose: To describe the prevalence and clinical characteristics of optic neuritis or neuropathy observed in the Ophthalmology Department of Gunma University Hospital.
Methods: In this retrospective study, consecutive patients with suspected optic nerve disorders seen at Gunma University Hospital from January 2016 to March 2019 were reviewed. The inclusion criteria were:(1)unilateral or bilateral acute visual disturbance or visual field disturbance;(2)positive relative afferent pupillary defect in unilateral cases or abnormalities in the optic disc. However, if anti-aquaporin 4(AQP4)or anti-myelin oligodendrocyte glycoprotein(MOG)antibodies or mitochondrial mutations were detected and both eyes revealed visual impairment, then both eyes were included; and(3)in bilateral cases, all patients required disc abnormalities in both eyes and magnetic resonance imaging(MRI)showing high-intensity in both optic nerves,(4)with no other retinal diseases. Then, the origins of optic neuritis or neuropathy were defined in all cases. All clinical characteristics were analyzed.
Results: A total of 112 eyes of 93 patients matched the criteria. Seventy-four patients showed unilateral acute visual impairment, and 59 eyes showed relative afferent pupillary defect and/or disc abnormality in 48 eyes. High-intensity MRI in the affected optic nerve was detected in 51 patients. Conversely, 38 eyes of 19 patients had bilateral acute visual loss, and a disc abnormality was detected in 20 eyes. MRI was abnormal in 25 optic nerves. Overall, major causes of optic neuritis or neuropathy were:(1)idiopathic optic neuritis(33 eyes of 32 cases, mean age ± standard deviation [years]: 49.8±16.4);(2)ischemic optic neuropathy(14 eyes of 14 cases, 71.4±11.4);(3)anti-AQP4 antibody-positive optic neuritis(12 eyes of eight cases, 53.2±14.0);(4)anti-MOG antibody-positive optic neuritis(five eyes of three cases, 10±10.6);(5)optic neuropathy due to compression by an orbital tumor(five eyes of five cases, 65.0±18.1);(6)Leber hereditary optic neuropathy(10 eyes of five cases, 51.8±12.2);(7)traumatic optic neuropathy(three eyes of three cases, 29.8±15.4);(8)rhinogenic optic neuropathy(three eyes of three cases, 61.0±12.0); and(9)optic neuropathy due to orbital apex syndrome(three eyes of three cases, 71.0±2.9). However, a definitive cause of optic nerve disorder could not be determined in 22 eyes of 16 cases.
Conclusions: The most common cause of optic nerve disorder in the patients examined in our department was idiopathic optic neuritis. Furthermore, ischemic optic neuropathy was the major cause in older patients.
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