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Visual field defects of optic neuritis in neuromyelitis optica compared with multiple sclerosis

BACKGROUND: Neuromyelitis optica (NMO) is an inflammatory demyelinating disease that predominantly affects the optic nerves and the spinal cord, and is possibly mediated by an immune mechanism distinct from that of multiple sclerosis (MS). Central scotoma is recognized as a characteristic visual fie...

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Autores principales: Nakajima, Hideto, Hosokawa, Takafumi, Sugino, Masakazu, Kimura, Fumiharu, Sugasawa, Jun, Hanafusa, Toshiaki, Takahashi, Toshiyuki
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904295/
https://www.ncbi.nlm.nih.gov/pubmed/20565857
http://dx.doi.org/10.1186/1471-2377-10-45
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author Nakajima, Hideto
Hosokawa, Takafumi
Sugino, Masakazu
Kimura, Fumiharu
Sugasawa, Jun
Hanafusa, Toshiaki
Takahashi, Toshiyuki
author_facet Nakajima, Hideto
Hosokawa, Takafumi
Sugino, Masakazu
Kimura, Fumiharu
Sugasawa, Jun
Hanafusa, Toshiaki
Takahashi, Toshiyuki
author_sort Nakajima, Hideto
collection PubMed
description BACKGROUND: Neuromyelitis optica (NMO) is an inflammatory demyelinating disease that predominantly affects the optic nerves and the spinal cord, and is possibly mediated by an immune mechanism distinct from that of multiple sclerosis (MS). Central scotoma is recognized as a characteristic visual field defect pattern of optic neuritis (ON), however, the differing pathogenic mechanisms of NMO and MS may result in different patterns of visual field defects for ON. METHODS: Medical records of 15 patients with NMO and 20 patients with MS having ON were retrospectively analyzed. A thorough systemic and neurological examination was performed for evaluating ON. The total number of relapses of ON and visual fields was investigated. Visual fields were obtained by Goldmann perimeter with each ON relapse. RESULTS: All MS patients experienced central scotoma, with 90% of them showing central scotoma with every ON relapse. However, 53% of NMO patients showed central scotoma with every ON relapse (p = 0.022), and the remaining 47% of patients experienced non-central scotoma (altitudinal, quadrant, three quadrant, hemianopia, and bitemporal hemianopia). Thirteen percent of NMO patients did not experience central scotoma during their disease course. Altitudinal hemianopia was the most frequent non-central scotoma pattern in NMO. CONCLUSIONS: NMO patients showed higher incidence of non-central scotoma than MS, and altitudinal hemianopia may be characteristic of ON occurring in NMO. As altitudinal hemianopia is highly characteristic of ischemic optic neuropathy, we suggest that an ischemic mechanism mediated by anti-aquaporin-4 antibody may play a role in ON in NMO patients.
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spelling pubmed-29042952010-07-15 Visual field defects of optic neuritis in neuromyelitis optica compared with multiple sclerosis Nakajima, Hideto Hosokawa, Takafumi Sugino, Masakazu Kimura, Fumiharu Sugasawa, Jun Hanafusa, Toshiaki Takahashi, Toshiyuki BMC Neurol Research Article BACKGROUND: Neuromyelitis optica (NMO) is an inflammatory demyelinating disease that predominantly affects the optic nerves and the spinal cord, and is possibly mediated by an immune mechanism distinct from that of multiple sclerosis (MS). Central scotoma is recognized as a characteristic visual field defect pattern of optic neuritis (ON), however, the differing pathogenic mechanisms of NMO and MS may result in different patterns of visual field defects for ON. METHODS: Medical records of 15 patients with NMO and 20 patients with MS having ON were retrospectively analyzed. A thorough systemic and neurological examination was performed for evaluating ON. The total number of relapses of ON and visual fields was investigated. Visual fields were obtained by Goldmann perimeter with each ON relapse. RESULTS: All MS patients experienced central scotoma, with 90% of them showing central scotoma with every ON relapse. However, 53% of NMO patients showed central scotoma with every ON relapse (p = 0.022), and the remaining 47% of patients experienced non-central scotoma (altitudinal, quadrant, three quadrant, hemianopia, and bitemporal hemianopia). Thirteen percent of NMO patients did not experience central scotoma during their disease course. Altitudinal hemianopia was the most frequent non-central scotoma pattern in NMO. CONCLUSIONS: NMO patients showed higher incidence of non-central scotoma than MS, and altitudinal hemianopia may be characteristic of ON occurring in NMO. As altitudinal hemianopia is highly characteristic of ischemic optic neuropathy, we suggest that an ischemic mechanism mediated by anti-aquaporin-4 antibody may play a role in ON in NMO patients. BioMed Central 2010-06-18 /pmc/articles/PMC2904295/ /pubmed/20565857 http://dx.doi.org/10.1186/1471-2377-10-45 Text en Copyright ©2010 Nakajima et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Nakajima, Hideto
Hosokawa, Takafumi
Sugino, Masakazu
Kimura, Fumiharu
Sugasawa, Jun
Hanafusa, Toshiaki
Takahashi, Toshiyuki
Visual field defects of optic neuritis in neuromyelitis optica compared with multiple sclerosis
title Visual field defects of optic neuritis in neuromyelitis optica compared with multiple sclerosis
title_full Visual field defects of optic neuritis in neuromyelitis optica compared with multiple sclerosis
title_fullStr Visual field defects of optic neuritis in neuromyelitis optica compared with multiple sclerosis
title_full_unstemmed Visual field defects of optic neuritis in neuromyelitis optica compared with multiple sclerosis
title_short Visual field defects of optic neuritis in neuromyelitis optica compared with multiple sclerosis
title_sort visual field defects of optic neuritis in neuromyelitis optica compared with multiple sclerosis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904295/
https://www.ncbi.nlm.nih.gov/pubmed/20565857
http://dx.doi.org/10.1186/1471-2377-10-45
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