The Studies On The Clinical Features Of Optic Neuritis And The Associations To The Polymorphism Of Apolipoprotein E Gene

[Objects]To analyze the clinical features of optic neuritis(ON) and the influences of ApoE gene polymorphism to primarily demylinating ON.[methods]186cases of ON from the department of ophthalmology in General Hospital of People’s Liberation Army from Jan1,2010to Oct1,2011were analyzed,including clinical data such as sex、age、symptoms、signs、laboratory examinations、MRI of brain, VEP and visual field(VF),got visual acuity(VA) for the first onset by reviews and follow-up visit on phone included:lowest VA,the VA for1week,1month and6month after onset(record best corrected visual acuity);Extracted DNA and tested ApoE gene polymorphism by the method of snapshot. Used SPSS17.0for data analysis.[results]1. There were186patients, the mean age was33.98±14.66years old,there were63males and123females. Among186cases which included:mutiple sclerosis(MS) in11cases,neuromyelitis optica(NMO) in10cases, idiopathic demylinating optic neuritis(Isolated ON)in134cases, autoimmune optic neuritis (AON) in19cases and infective optic neuritis(ION) in12cases.2.In the first onset, there were186eyes’visual acuity<0.05,there were no difference among the groups of ON(P>0.05). There were132eyes’visual acuity>0.5in6month later ION is more than MSON and unilateral-RION(P<0.05).3.Optic disc edema was found in52of125eyes during the acute stage.4.163patients examed brain by MRI，34cases had demylinating leisures,20cases had optic nerve abnormalities,16cases had demylinating leisures in the brain.5.134cases had AQP4test,31cases were positive,the rate of which from MS is50%, from NMO is57.14%,from Isolated ON is12.61%,from AON is60.00%,ION is undetected.The rate of AON is more than Isolated ON (P<0.05).6.67Isolated ON patients had Torch test,from which there were24cases whose IgM is positive (35.83%)7.77cases took antinuclear antibody spectrum test,from which16cases were positive(20.78%).In the19cases of AON group,there were13patients who didn’t have identify autoimmune disease but serology is abnormal,6patients had identify autoimmune diseases.8.141cases of primarily demylinating ON took ApoE gene test,the genotype were:no case for E2E2,96cases for E3E3,1case for E4E4,17cases for E2E3,25cases for E3E4,2cases for E2E4.The allele were:19for ε2,234for ε3,29for ε4. In the first onset,the visual acuity of the eyes which carry e4allele or not were different in the lowest level(P<0.05),also different in half a year prognosis(P<0.01).The ratio that VA<0.05is bigger in the former.18cases were binocular involved in the former and57cases in the later,13eyes were pain and15eyes were not pain in the former.53eyes were pain and60eyes were not pain in the later.In the acute stage,there were12eyes with optic edema and19eyes without in the former group,there were33eyes with optic edema and56eyes without in the later group.There were no significant differences between them (P>0.05)[conclusions]1. Age of onset was usually concentrated in young females, Isolated ON is the main type of ON, followed by AON, ION, MS and NMO.2. In the6months after the first onset, ION is more than MSON and unilateral-RION of the ratio that visual acuity>0.5.3.The detection rate of demyelination of optic nerve on MRI was low, only12.27%.4. The detection rate of antinuclear antibody spectrum test is20.78%,AON was easy to be find optic disc edema and the positive result of AQP4test.5.The detection rate of IgM of Torch test was35.82%, which was higher than the population census in other cities or provinces,there might be some relationships from Torch to Isolated ON,the rigorous control trail is needed.6.For the firet onset of primarily demylinating ON, in the lowest visual acuity or half a year prognosis,there were difference between the eyes of carrying ε4allele and not. The ratio that VA≤0.05is bigger in the ε4allele group.There were no relation between them in binoculus involved,ophthalmalgia nor optic edema(P>0.05).