The Analysis Of Related Factors For Optic Neuropathy In Patients With Neuromyelitis Optica Spectrum Disorders

Objective : To analyse the clinical,blood,cerebrospinal fluid characteristics of neuromyelitis optica spectrum disorders(NMOSD)patients with optic neuropathy.Explore related factors and significance for optic neuropathy in patients with neuromyelitis optica spectrum disorders.Methods:We retrospectively analysed 108 NMOSD patients totally from January 2010 to February 2016 in Changhai Hospital,who were in accordance with the 2015 internatinal consensus and diagnostic criteria.The clinical and biochemical data of NMOSD patients were collected.Patients were divided into the optic neuropathy groups and no optic neuropathy groups,and their clinical、biochemical characteristics were compared between the two groups.According to serum AQP4-Ab,NMOSD patients were divided into AQP4-Ab seropositive and seronegative groups,their clinical、biochemical features were compared between the two groups.The relation between the optic neuropathy and AQP4-Ab/serum creatinine was analyzed through the statistical methods of Pearson and Spearman correlation analysis research to discuss the pathogenesis of optic neuropathy in NMOSD.Accoding to SCR tertiles and gender,incidences of vision impaired were compared among whole groups and explored the odds ratios of vision impaired across the tertile’s SCR level by multivariate analysis。Results:A total of 108 patients diagnosed with NMOSD,including 53 cases of patients with optic neuropathy,55 cases of patients without optic neuropathy,Between the two groups,there were no significant differences in gender,age of onset,disease course、white blood cells,serum alanine transferase(ALT),CSF-protein,CSF-IgG、oligoclonal band(P>0.05),and there were statistically significant differences in relapse frequencies,serum creatinine(Scr)and serum AQP4-Ab(P<0.05).There were 50 cases of AQP4-Ab seropositive and 17 cases of AQP4-Ab seronegative.Between the two groups by serum AQP4-Ab,there were statistically significant differences in the incidence of optic neuropathy.(X2=8.267,P < 0.05).The incidenceof optic neuropathy was positively correlated with AQP4-Ab(r=0.351,P<0.05).In the optic neuropathy groups,54.00μmol/L of Scr median,interquartile 15.00μmol/L,while in the no optic neuropathy groups,61.00μμmol/LofScr median,interquartile 24.00μmol/L,there were statistically significant differences in Scr between the two groups(P=0.018).The incidenceof optic neuropathy was negatively correlated with AQP4-Ab(r=-0.260,P<0.05).There was a significant difference on SCR level between groups with and without vision impaired in whole patients,and the difference persisted in male patients by hierarchical analysis(P=0.024).Incidences of vision impaired were different among three male groups by SCR tertile(P=0.048).The odds ratios(95% CI)of vision impaired across the tertile’s SCR level were 1(reference),0.33(0.03,4.20),and 0.05(0.00,0.82)in male groupsafter adjusting for age,attack frequency,gastrointestinal infection,AQP4-Ab,it meant protective effect of SCR enhanced in male groups.Conclusion:The results showed that NMOSD patients with AQP4-Ab seropositive could be prone to have optic neuropathy,AQP4-Ab could be a risk factor,thecorrelation may be beneficial to early diagnosis,therapy and monitoring of NMOSD.The study confirmed elevated serum creatinine may decline the incidence of vision damage.The correlation predicts SCR level could be considered as a protective factor for optic neuropathy in patients with NMOSD,as for male groups especially.Further studies are required with larger number of patients and follow-up study to identify the value of SCR level inoptic neuropathy in NMOSDpatients.