Visual Outcomes Following Plasma Exchange for Optic Neuritis: An International Multicenter Retrospective Analysis of 395 Optic Neuritis Attacks
Issued Date
2023-08-01
Resource Type
ISSN
00029394
eISSN
18791891
Scopus ID
2-s2.0-85158108269
Pubmed ID
36822570
Journal Title
American Journal of Ophthalmology
Volume
252
Start Page
213
End Page
224
Rights Holder(s)
SCOPUS
Bibliographic Citation
American Journal of Ophthalmology Vol.252 (2023) , 213-224
Suggested Citation
Chen J.J., Flanagan E.P., Pittock S.J., Stern N.C., Tisavipat N., Bhatti M.T., Chodnicki K.D., Tajfirouz D.A., Jamali S., Kunchok A., Eggenberger E.R., Nome M.A.D., Sotirchos E.S., Vasileiou E.S., Henderson A.D., Arnold A.C., Bonelli L., Moss H.E., Navarro S.E.V., Padungkiatsagul T., Stiebel-Kalish H., Lotan I., Wilf-Yarkoni A., Danesh-Meyer H., Ivanov S., Huda S., Forcadela M., Hodge D., Poullin P., Rode J., Papeix C., Saheb S., Boudot de la Motte M., Vignal C., Hacohen Y., Pique J., Maillart E., Deschamps R., Audoin B., Marignier R. Visual Outcomes Following Plasma Exchange for Optic Neuritis: An International Multicenter Retrospective Analysis of 395 Optic Neuritis Attacks. American Journal of Ophthalmology Vol.252 (2023) , 213-224. 224. doi:10.1016/j.ajo.2023.02.013 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/82858
Title
Visual Outcomes Following Plasma Exchange for Optic Neuritis: An International Multicenter Retrospective Analysis of 395 Optic Neuritis Attacks
Author(s)
Chen J.J.
Flanagan E.P.
Pittock S.J.
Stern N.C.
Tisavipat N.
Bhatti M.T.
Chodnicki K.D.
Tajfirouz D.A.
Jamali S.
Kunchok A.
Eggenberger E.R.
Nome M.A.D.
Sotirchos E.S.
Vasileiou E.S.
Henderson A.D.
Arnold A.C.
Bonelli L.
Moss H.E.
Navarro S.E.V.
Padungkiatsagul T.
Stiebel-Kalish H.
Lotan I.
Wilf-Yarkoni A.
Danesh-Meyer H.
Ivanov S.
Huda S.
Forcadela M.
Hodge D.
Poullin P.
Rode J.
Papeix C.
Saheb S.
Boudot de la Motte M.
Vignal C.
Hacohen Y.
Pique J.
Maillart E.
Deschamps R.
Audoin B.
Marignier R.
Flanagan E.P.
Pittock S.J.
Stern N.C.
Tisavipat N.
Bhatti M.T.
Chodnicki K.D.
Tajfirouz D.A.
Jamali S.
Kunchok A.
Eggenberger E.R.
Nome M.A.D.
Sotirchos E.S.
Vasileiou E.S.
Henderson A.D.
Arnold A.C.
Bonelli L.
Moss H.E.
Navarro S.E.V.
Padungkiatsagul T.
Stiebel-Kalish H.
Lotan I.
Wilf-Yarkoni A.
Danesh-Meyer H.
Ivanov S.
Huda S.
Forcadela M.
Hodge D.
Poullin P.
Rode J.
Papeix C.
Saheb S.
Boudot de la Motte M.
Vignal C.
Hacohen Y.
Pique J.
Maillart E.
Deschamps R.
Audoin B.
Marignier R.
Author's Affiliation
Ramathibodi Hospital
Queen Square Multiple Sclerosis Centre
The Walton Centre NHS Foundation Trust
Centre de Résonance Magnétique Biologique et Médicale
Permanente Medical Group
Fondation Adolphe de Rothschild
University of California, Los Angeles
Mayo Clinic Scottsdale-Phoenix, Arizona
Hopital Neurologique et Neurochirurgical Pierre Wertheimer
Cleveland Clinic Foundation
Great Ormond Street Hospital for Children NHS Foundation Trust
Hôpital Universitaire Pitié Salpêtrière
Stanford University
The University of Auckland
Tel Aviv University
Mayo Clinic
Johns Hopkins University
AP-HM Assistance Publique - Hôpitaux de Marseille
Mayo Clinic in Jacksonville, Florida
Johns Hopkins School of Medicine
S.J.P.)
S.J.)
Departments of Ophthalmology (M.A.D.N.)
A.K.)
E.M.)
Queen Square Multiple Sclerosis Centre
The Walton Centre NHS Foundation Trust
Centre de Résonance Magnétique Biologique et Médicale
Permanente Medical Group
Fondation Adolphe de Rothschild
University of California, Los Angeles
Mayo Clinic Scottsdale-Phoenix, Arizona
Hopital Neurologique et Neurochirurgical Pierre Wertheimer
Cleveland Clinic Foundation
Great Ormond Street Hospital for Children NHS Foundation Trust
Hôpital Universitaire Pitié Salpêtrière
Stanford University
The University of Auckland
Tel Aviv University
Mayo Clinic
Johns Hopkins University
AP-HM Assistance Publique - Hôpitaux de Marseille
Mayo Clinic in Jacksonville, Florida
Johns Hopkins School of Medicine
S.J.P.)
S.J.)
Departments of Ophthalmology (M.A.D.N.)
A.K.)
E.M.)
Other Contributor(s)
Abstract
PURPOSE: To evaluate the effectiveness of plasma exchange (PLEX) for optic neuritis (ON). METHODS: We conducted an international multicenter retrospective study evaluating the outcomes of ON following PLEX. Outcomes were compared to raw data from the Optic Neuritis Treatment Trial (ONTT) using a matched subset. RESULTS: A total of 395 ON attack treated with PLEX from 317 patients were evaluated. The median age was 37 years (range 9-75), and 71% were female. Causes of ON included multiple sclerosis (108), myelin oligodendrocyte glycoprotein antibody–associated disease (MOGAD) (92), aquaporin-4-IgG–positive neuromyelitis optica spectrum disorder (AQP4+NMOSD) (75), seronegative-NMOSD (34), idiopathic (83), and other (3). Median time from onset of vision loss to PLEX was 2.6 weeks (interquartile range [IQR], 1.4-4.0). Median visual acuity (VA) at the time of PLEX was count fingers (IQR, 20/200-hand motion), and median final VA was 20/25 (IQR, 20/20-20/60) with no differences among etiologies except MOGAD-ON, which had better outcomes. In 81 (20.5%) ON attacks, the final VA was 20/200 or worse. Patients with poor outcomes were older (P = .002), had worse VA at the time of PLEX (P < .001), and longer delay to PLEX (P < .001). In comparison with the ONTT subset with severe corticosteroid-unresponsive ON, a final VA of worse than 20/40 occurred in 6 of 50 (12%) PLEX-treated ON vs 7 of 19 (37%) from the ONTT treated with intravenous methylprednisolone without PLEX (P = .04). CONCLUSION: Most ON attacks improved with PLEX, and outcomes were better than attacks with similar severity in the ONTT. The presence of severe vision loss at nadir, older age, and longer delay to PLEX predicted a worse outcome whereas MOGAD-ON had a more favorable prognosis.