Serial analyses of clinical spectra and outcomes in Chinese women with pregnancy-induced optic neuritis

Wenhao Bai; Mingming Sun; Honglu Song; Hongen Li; Xintong Xu; Xiyun Chen; Yixuan Zhao; Biyue Chen; Sheng Yao; Quangang Xu; Shihui Wei; Huanfen Zhou; Shengyuan Yu

doi:10.3389/fmed.2022.1067277

Serial analyses of clinical spectra and outcomes in Chinese women with pregnancy-induced optic neuritis

Front Med (Lausanne). 2022 Nov 25:9:1067277. doi: 10.3389/fmed.2022.1067277. eCollection 2022.

Authors

Affiliations

¹ Department of Neurology, The First Medical Centre of Chinese PLA General Hospital, Beijing, China.
² Senior Department of Ophthalmology, The Third Medical Centre of Chinese PLA General Hospital, Beijing, China.
³ Department of Ophthalmology, Changping Maternal and Child Health Care Hospital, Beijing, China.

Abstract

Objective: This study aimed to investigate the clinical spectra and outcomes in pregnancy-related optic neuritis (ON).

Methods: We analyzed the clinical subtype and prognosis of women with pregnancy-related ON in the neuro-ophthalmology department of the First Medical Center at the Chinese PLA General Hospital from January 2014 to December 2019.

Results: A total of 54 patients, including 21 (38.9%) with idiopathic ON (ION), 27 (50.0%) with aquaporin-4 (AQP4)-ON, and 6 (11.6%) with myelin oligodendrocyte glycoprotein (MOG)-ON, who experienced 58 informative pregnancies and 67 episodes of pregnancy-related ON were assessed. Among the ON attacks, there were 11 (16.4%) during pregnancy and 56 (83.6%) within 1 year postpartum (PP1) or after abortion, including 33 (49.3%) in the first trimester. In total, 14 (25.9%) patients with ON onset before pregnancy had a higher relapse rate during PP1 than within 1 year before pregnancy (p = 0.021), and 24 (85.7%) eyes with ION and nine (100%) with MOG-ON had significantly better visual outcomes (p ≥ 0.5) than those with AQP4-ON (14, 35%) (p < 0.001 and p < 0.001, respectively). Two AQP4-ON patients had premature birth and low baby weight, respectively. There were no birth defects or stillbirths.

Conclusion: The significantly increased relapse rate and numerous cases of ON after pregnancy suggest that delivery adversely affects the course of ON.

Keywords: anti-aquaporin-4 antibody; myelin oligodendrocyte glycoprotein; optic neuritis; pregnancy; therapy.