| Purpose:Through relevant examinations on patients with neuromyelitis optica spectrum disorder(NMOSD),we can understand the relationship between the onset of optic neuritis(ON)and visual function and optic nerve damage,explore the characteristics of retinal and choroidal structural damage,and further understand the impact of visual function and neurodegenerative process of patients with NMOSD after ON,so as to achieve early intervention and timely treatment,The purpose of reducing visual impairment.Methods:A total of 23 NMOSD patients who met the inclusion criteria in the Neurology and Ophthalmology departments of the First Affiliated Hospital of Dalian Medical University from January 2020 to May 2022 were collected,and their case data was recorded and followed up.With the number of ON attacks as the grouping standard,they were divided into three groups: the non ON attack group,the single ON attack group and the multiple ON attacks group.The demography data,aquaporin-4 antibodies(AQP4Ab),best corrected visual acuity(BCVA),dynamic visual field measurement,and optical coherence tomography(OCT)results between the groups were compared to see if there were significant differences.Using SPSS26.0 software for statistical analysis,P<0.05 indicates statistical significance.Results:1.There was no statistically significant difference in the average age(P=0.728,P>0.05)and average age of first onset(P=0.520,P>0.05)among the groups with no ON attack,single ON attack,and two or more ON attacks.2.There was no statistically significant difference in the positive rate of AQP4-Ab among NMOSD patients with no ON attack,single ON attack,and two or more ON attacks(P=0.765,P>0.017)3.There was no statistically significant difference in BCVA(P=0.284,P>0.05),weighted field of view index(VFI)(P=0.121,P>0.05),mean defect(MD)(P=0.122,P>0.05),and pattern standard deviation(PSD)(P=0.100,P>0.05)between eyes without ON attacks and those with single ON attacks in NMOSD patients,However,there was a significant difference(P<0.001)between eyes without ON attacks and eyes with 2 or more ON attacks.4.In NMOSD patients,there was no statistical difference in the average thickness of the subfoveal choroidal layer(SCL)(P=0.879,P>0.05)and the inner nuclear layer(INL)(P=0.617,P>0.05)between the groups.The retinal nerve fiber layer(RNFL)(P=0.124,P>0.05),ganglion cell layer(GCL)(P=0.107,P>0.05),inner plexiform layer(IPL There was a significant difference in the average thickness of IPL between eyes without ON attacks and eyes with 2 or more ON attacks(P<0.001).5.The RNFL thickness of the optic disc in NMOSD patients in various quadrants(nasal quadrant,superior nasal quadrant,superior temporal quadrant,temporal quadrant,inferior temporal quadrant,inferior nasal quadrant)showed no statistically significant difference(P>0.05)between the eyes without ON attacks and those with single ON attacks,but there was a significant difference(P<0.001)between the eyes without ON attacks and those with two or more ON attacks.Conclusion:1.The first ON attack of NMOSD has relatively minor damage to visual function,optic nerve,and retina.However,the accumulation of optic nerve and retinal atrophy after multiple attacks can cause irreversible damage to visual function.2.There is no correlation between the number of ON episodes and AQP4-Ab in NMOSD patients.3.After ON seizure,NMOSD patients will damage RNFL,GCL and IPL,but not INL and SCL,which indicates that the degenerative changes caused by ON seizure in NMOSD patients may start from the axons of retinal ganglion cell,enter the cell body,and stop at the dendrites of ganglion cells,but do not damage the deeper retinal and choroidal structures. |
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