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Journal of Inflammation Research 2024Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a rare, benign, and self-limiting condition characterized by lymph node...
Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a rare, benign, and self-limiting condition characterized by lymph node inflammation. While KFD is rarely associated with ocular manifestations, our case report highlights bilateral optic neuritis in a 13-year-old male patient with KFD. We also provide a comprehensive review of similar cases in the literature.
PubMed: 38751686
DOI: 10.2147/JIR.S458990 -
Multiple Sclerosis (Houndmills,... Jun 2024Alterations of the superficial retinal vasculature are commonly observed in multiple sclerosis (MS) and can be visualized through optical coherence tomography...
BACKGROUND
Alterations of the superficial retinal vasculature are commonly observed in multiple sclerosis (MS) and can be visualized through optical coherence tomography angiography (OCTA).
OBJECTIVES
This study aimed to examine changes in the retinal vasculature during MS and to integrate findings into current concepts of the underlying pathology.
METHODS
In this cross-sectional study, including 259 relapsing-remitting MS patients and 78 healthy controls, we analyzed OCTAs using deep-learning-based segmentation algorithm tools.
RESULTS
We identified a loss of small-sized vessels (diameter < 10 µm) in the superficial vascular complex in all MS eyes, irrespective of their optic neuritis (ON) history. This alteration was associated with MS disease burden and appears independent of retinal ganglion cell loss. In contrast, an observed reduction of medium-sized vessels (diameter 10-20 µm) was specific to eyes with a history of ON and was closely linked to ganglion cell atrophy.
CONCLUSION
These findings suggest distinct atrophy patterns in retinal vessels in patients with MS. Further studies are necessary to investigate retinal vessel alterations and their underlying pathology in MS.
Topics: Humans; Female; Cross-Sectional Studies; Tomography, Optical Coherence; Male; Adult; Retinal Vessels; Multiple Sclerosis, Relapsing-Remitting; Middle Aged; Optic Neuritis; Retinal Ganglion Cells; Deep Learning; Atrophy; Cost of Illness
PubMed: 38751230
DOI: 10.1177/13524585241247775 -
Journal of Neurosciences in Rural... 2024Demyelinating diseases of central nervous system (CNS) are a broad spectrum of conditions with autoimmune process against myelin. In a resource limited country like...
OBJECTIVES
Demyelinating diseases of central nervous system (CNS) are a broad spectrum of conditions with autoimmune process against myelin. In a resource limited country like India, it is imperative to perform proper clinical evaluation, neuroimaging to differentiate among various categories of CNS demyelinating diseases to decide regarding further workup and treatment. The objective of our study was to determine clinical presentation, imaging findings, serology results, diagnosis, and treatment outcome of primary demyelinating disorders of CNS.
MATERIALS AND METHODS
In this prospective study, a total of 44 patients were enrolled over a period of 1 year. After proper evaluation, patients were categorized into different groups applying newer diagnostic criteria. Patients were treated with steroids, appropriate immunomodulatory therapy, and outcomes were analyzed.
RESULTS
The majority of cases were of neuromyelitis optica spectrum disorder (NMOSD) (45.5%) with an overall female-to-male ratio of 3.4:1 and mean age of presentation was 30.5 ± 11.15. Myelitis (52.3%) followed by optic neuritis (45.5%) was the most common initial presentation. The most common site of involvement on magnetic resonance imaging was the spinal cord (particularly the cervicodorsal cord). The majority showed good response to therapy (77.27%) and two patients did not survive.
CONCLUSION
Higher disability observed among seropositive NMOSD patients warrants aggressive treatment during the first attack itself. It is important to suspect myelin oligodendrocyte glycoprotein antibody disease in patients with preceding viral infection. A good outcome in the majority is likely due to the availability of serological assays and aggressive immunomodulatory therapy.
PubMed: 38746498
DOI: 10.25259/JNRP_603_2023 -
Cureus Apr 2024Leptomeningeal metastasis (LMM) is a rare complication of non-small cell lung cancer (NSCLC) that can present with a range of neurological symptoms depending on the...
Leptomeningeal metastasis (LMM) is a rare complication of non-small cell lung cancer (NSCLC) that can present with a range of neurological symptoms depending on the site(s) of metastatic involvement. We present a case of a 54-year-old woman who was initially diagnosed with suspected inflammatory neuritis secondary to a known systemic lupus erythematosus (SLE) diagnosis after presenting with multiple months of progressive neuro-ophthalmologic symptoms; however, she was eventually diagnosed with LMM secondary to a previously undiagnosed NSCLC. This case both underscores the challenges of diagnosing LMM due to its nonspecific presentation, as well as highlights the importance of including LMM in the differential diagnosis for patients presenting with vague neurological symptoms in the context of another inflammatory disease process.
PubMed: 38741820
DOI: 10.7759/cureus.58209 -
Journal of Neuro-ophthalmology : the... Jun 2024
Topics: Humans; Optic Neuritis; Cytomegalovirus Infections; Cytomegalovirus; Immunocompetence; Male; Female; Magnetic Resonance Imaging; Eye Infections, Viral
PubMed: 38741247
DOI: 10.1097/WNO.0000000000001834 -
The Annals of Otology, Rhinology, and... May 2024This study compared the utilization and outcomes of face-to-face (F2F) vestibular support groups and online support communities (OSC) for individuals with vestibular...
OBJECTIVE
This study compared the utilization and outcomes of face-to-face (F2F) vestibular support groups and online support communities (OSC) for individuals with vestibular disorders.
METHODS
We distributed a 31-question anonymous electronic survey through the Vestibular Disorders Association (VeDA) to F2F participants, categorizing user involvement in F2F, OSCs, or both and assessed impact on medical decision-making, psychosocial benefits, and goals achieved.
RESULTS
The F2F cohort consisted of 97 individuals comprising primarily of non-Hispanic White women (mean age = 57 years, SD ± 14 years) with diagnoses including persistent postural-perceptual dizziness (19%), Meniere's disease (15%), and vestibular neuritis (13%). Most participants were diagnosed by an otolaryngologist (65%) and attended F2F meetings monthly or less frequently (78%). The OSC group comprised of 551 individuals, primarily of non-Hispanic White women, but was younger in age (mean age = 50 years, SD ± 13 years). OSC participants notably engaged more, with 36% participating on a daily basis and 32% multiple times a week. F2F participants were older (mean age 57 years vs 50 years, < .001) and more commonly referred by medical professionals (22% F2F vs 6% OSC, < .001). Both groups had similar achieved goals, including hearing from others with the same diagnosis (84% vs 89%, > .05) and similar impact on medical decision-making (75% vs 78%, > .05). More F2F participants reported increased development of coping skills (79% F2F vs 69% OSC, = .037). OSC participants typically found the group via an online search (75%), compared to 51% for F2F. OSC participants had higher daily engagement (36%) compared to F2F (1%).
CONCLUSION
F2F users are older and more commonly referred by medical professionals. Despite less frequent engagement, F2F participants reported similar influences on achieved goals, medical decision-making, and impact on psychosocial benefits. These findings highlight the importance of both F2F and OSC support groups for individuals with vestibular disorders.
PubMed: 38738670
DOI: 10.1177/00034894241241861 -
Laryngoscope Investigative... Jun 2024Comprehensive studies in which the seasonal variation in peripheral vestibular disorders was evaluated using data from an entire population are insufficient. The...
OBJECTIVES
Comprehensive studies in which the seasonal variation in peripheral vestibular disorders was evaluated using data from an entire population are insufficient. The seasonal variation in peripheral vestibular disorders based on data from the entire Korean population was investigated in the present study.
METHODS
Retrospective data from the National Health Insurance Service of Korea from 2008 to 2020 was analyzed. Benign paroxysmal positional vertigo (BPPV), vestibular neuritis (VN), and Meniere's disease (MD) were defined based on diagnostic, treatment, or audiovestibular test codes. The seasonal incidence for each peripheral vestibular disorder was calculated among all study subjects.
RESULTS
For the entire study cohort, the incidence of BPPV was significantly higher in spring (odds ratio [OR] = 1.031, 95% confidence interval [CI] = 1.026-1.037), autumn (OR = 1.024, 95% CI = 1.019-1.029), and winter (OR = 1.051, 95% CI = 1.046-1.056) than in summer. The incidence of VN was significantly lower in winter (OR = 0.917, 95% CI = 0.907-0.927) than in summer. The incidence of MD was significantly higher in spring (OR = 1.027, 95% CI = 1.015-1.039) and autumn (OR = 1.029, 95% CI = 1.017-1.041) and significantly lower in winter (OR = 0.919, 95% CI = 0.908-0.931) than in summer. Differences were also observed in seasonal variation based on sex and age.
CONCLUSIONS
Significant seasonal variation occurred in peripheral vestibular disorders including BPPV, VN, and MD based on the entire Korean population data. Furthermore, seasonal variation showed differences based on sex and age.
LEVEL OF EVIDENCE
4.
PubMed: 38736946
DOI: 10.1002/lio2.1254 -
Diagnostics (Basel, Switzerland) Apr 2024Neuromyelitis optica (NMO) and neuromyelitis optica spectrum disorder (NMOSD) are autoimmune-mediated central nervous system disorders distinguished by the presence of... (Review)
Review
OBJECTIVE
Neuromyelitis optica (NMO) and neuromyelitis optica spectrum disorder (NMOSD) are autoimmune-mediated central nervous system disorders distinguished by the presence of serum aquaporine-4 IgG antibody (AQP4-Ab). The clinical panel comprises severe optic neuritis (ON) and transverse myelitis, which can result in incomplete recovery and a high risk of recurrence.
METHODS
This study aimed to evaluate the visual outcomes of three patients with severe acute ON in NMOSD that was non-responsive to intravenous methylprednisolone (IVMP), who received plasma exchange therapy (PLEX). We included three patients (P1, P2 and P3) with severe acute ON who had no improvement after IVMP treatment and were admitted to the ophthalmology department at the Emergency University Hospital Bucharest from January 2022 to September 2023. All three patients with ON were diagnosed in accordance with the criteria described by the Optic Neuritis Treatment Trial. All the subjects were experiencing their first attack.
RESULTS
The mean recruitment age was 35.3 ± 7.71. All patients were seropositive for the AQP4 antibody. All patients were tested for serum myelin oligodendrocyte glycoprotein (MOG) antibody but only one showed a positive test (P3). Lesions visible in orbital MRI indicated the involvement of retrobulbar, canalicular and/or intracranial segments. All three subjects had no response or incomplete remission after an IVMP protocol (5 days of 1000 mg intravenous methylprednisolone in sodium chloride 0.9%). The mean time from onset of optic neuritis to PLEX was 37.6 days. The PLEX treatment protocol comprised five cycles of plasma exchange treatment over 10 days, with a plasma exchange session every other day. An amount of 1 to 1.5 volumes of circulating plasma were dialyzed for 2-4 h. At 1 month after the completion of PLEX therapy, BCVA and VF parameters were improved in all three patients.
CONCLUSION
The treatment of ON remains subject to debate and is somewhat controversial. Plasma exchange must be considered as a rescue therapy when IVMP is insufficient for AQP4-ON patients. This study revealed that PLEX treatment effectively improves the visual outcomes of patients experiencing their first attack of severe acute isolated ON after high-dose IVMP treatment. This study suggests that PLEX may be associated with improved visual outcomes in NMOSD acute optic neuritis.
PubMed: 38732279
DOI: 10.3390/diagnostics14090863 -
International Journal of Molecular... Apr 2024Vaccination is a public health cornerstone that protects against numerous infectious diseases. Despite its benefits, immunization implications on ocular health warrant... (Review)
Review
Vaccination is a public health cornerstone that protects against numerous infectious diseases. Despite its benefits, immunization implications on ocular health warrant thorough investigation, particularly in the context of vaccine-induced ocular inflammation. This review aimed to elucidate the complex interplay between vaccination and the eye, focusing on the molecular and immunological pathways implicated in vaccine-associated ocular adverse effects. Through an in-depth analysis of recent advancements and the existing literature, we explored various mechanisms of vaccine-induced ocular inflammation, such as direct infection by live attenuated vaccines, immune complex formation, adjuvant-induced autoimmunity, molecular mimicry, hypersensitivity reactions, PEG-induced allergic reactions, Type 1 IFN activation, free extracellular RNA, and specific components. We further examined the specific ocular conditions associated with vaccination, such as uveitis, optic neuritis, and retinitis, and discussed the potential impact of novel vaccines, including those against SARS-CoV-2. This review sheds light on the intricate relationships between vaccination, the immune system, and ocular tissues, offering insights into informed discussions and future research directions aimed at optimizing vaccine safety and ophthalmological care. Our analysis underscores the importance of vigilance and further research to understand and mitigate the ocular side effects of vaccines, thereby ensuring the continued success of vaccination programs, while preserving ocular health.
Topics: Humans; Vaccination; COVID-19 Vaccines; Eye; SARS-CoV-2; COVID-19; Vaccines; Animals; Eye Diseases
PubMed: 38731972
DOI: 10.3390/ijms25094755 -
Journal of Clinical Medicine May 2024Optic neuritis (ON) is a condition marked by optic nerve inflammation due to various potential triggers. Research indicates a link between telomeres and inflammation, as...
Optic neuritis (ON) is a condition marked by optic nerve inflammation due to various potential triggers. Research indicates a link between telomeres and inflammation, as studies demonstrate that inflammation can lead to increased telomere shortening. : We aimed to determine the associations of telomere-related telomeric repeat binding factor 1 () rs1545827, rs10107605, and telomeric repeat binding factor 2 ) rs251796 polymorphisms and relative leukocyte telomere length (LTL) with the occurrence of ON. : In this research, a total of 73 individuals diagnosed with optic neuritis (ON) were studied and the control group included 170 individuals without any health issues. The DNA samples were obtained from peripheral blood leukocytes, which were purified using the DNA salting-out technique. Real-time polymerase chain reaction (RT-PCR) assessed single-nucleotide polymorphisms (SNPs) and relative leukocyte telomere lengths (LTL). The data obtained were processed and analyzed using the "IBM SPSS Statistics 29.0" program. : Our study revealed the following results: in the male group, rs251796 (AA, AG, and TT) statistically significantly differed between the long and short telomere group, with frequencies of 65.7%, 22.9%, and 2.0% in long telomeres, compared to 35.1%, 56.8%, and 8.1% in the short telomere group ( = 0.013). The rs251796 CT genotype, compared to CC, under the codominant genetic model, was associated with 4.7-fold decreased odds of telomere shortening ( = 0.005). Meanwhile, CT+TT genotypes, compared to CC under the dominant genetic model, were associated with 3.5-fold decreased odds of telomere shortening ( = 0.011). Also, the CT genotype, compared to CC+TT, under the overdominant genetic model, was associated with 4.4-fold decreased odds of telomere shortening ( = 0.004). : The current evidence may suggest a protective role of rs251796 in the occurrence of ON in men.
PubMed: 38731223
DOI: 10.3390/jcm13092694