Subclinical damage to the contralateral eye in unilateral optic neuritis: A longitudinal study

Yurong Zhang; Yao Qiu; Leyan Chen; Taimin Guo; Xiaoyu Xu; Xiaoning Liu; Yue Fu; Kaiqun Liu; Xinnan Li; Xin Ren; Zhiqiang Xiao; Siqi Chen; Hui Yang

doi:10.1016/j.msard.2023.104923

Subclinical damage to the contralateral eye in unilateral optic neuritis: A longitudinal study

Mult Scler Relat Disord. 2023 Oct:78:104923. doi: 10.1016/j.msard.2023.104923. Epub 2023 Jul 29.

Authors

Yurong Zhang¹, Yao Qiu¹, Leyan Chen¹, Taimin Guo¹, Xiaoyu Xu¹, Xiaoning Liu¹, Yue Fu¹, Kaiqun Liu¹, Xinnan Li¹, Xin Ren¹, Zhiqiang Xiao¹, Siqi Chen¹, Hui Yang²

Affiliations

¹ State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University.
² State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University. Electronic address: yanghui9@hotmail.com.

PMID: 37562198
DOI: 10.1016/j.msard.2023.104923

Abstract

Background: Early detection of subclinical injuries can lead to a correct diagnosis and help control the advancement of the condition. This study aims to investigate the presence of subclinical damage and silent progression to the contralateral eye's visual function and structure in patients experiencing their first episode of unilateral optic neuritis (ON).

Methods: Fifty patients with first-onset unilateral ON were enrolled in this study. Based on etiology, they were classified as having neuromyelitis optica spectrum disorder-related ON (NMOSD-ON), myelin oligodendrocyte glycoprotein antibody-associated ON (MOG-ON), idiopathic ON (IDON), or multiple sclerosis-related ON (MS-ON). These cases were followed up for one year to determine whether there was any silent progression of visual function and structure in the contralateral non-ON (NON) eye. A gender- and age-matched healthy control (HC) group was included to compare the differences in visual function and structure between the patients with NON eyes and the HC group.

Results: Within two weeks of onset, best-corrected visual acuity (BCVA; P = 0.008), mean deviation (MD) of the visual field (VF) (P = 0.001), and peripapillary retinal nerve fiber layer (pRNFL; P = 0.019) thickness were significantly worse in the NMOSD-NON patients than those in the HC group, while there were no differences in the pRNFL and the ganglion cell-inner plexiform layer (GCIPL) thicknesses and quadrant thicknesses (P > 0.05) of the groups. IDON-NON only showed subclinical damage in VF (P = 0.001) and temporal pRNFL (P = 0.042), while the BCVA, VF, and optic nerve structure (pRNFL, GCIPL) of the MOG-NON patients showed no subclinical damage (P > 0.05). In addition, the one-year follow-up of each NON eye type showed that there was no silent progression in NMOSD-NON, MOG-NON, or IDON-NON. A pairwise comparison of the different types of NON eyes revealed no statistical differences (P > 0.05).

Conclusion: Among the patients with unilateral ON, NMOSD-NON and IDON-NON resulted in subclinical damage to the visual function and structure of the contralateral eye within two weeks of onset, whereas MOG-NON did not show any subclinical damage to visual function or structure. Furthermore, these subclinical damages did not show any silent progression during the one-year follow-up period.

Keywords: Optic neuritis; myelin oligodendrocyte glycoprotein antibody-related disease; neuromyelitis optica spectrum disorder; subclinical; visual outcomes.