Ophthalmology in China ›› 2022, Vol. 31 ›› Issue (5): 381-385.doi: 10.13281/j.cnki.issn.1004-4469.2022.05.012

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Efficacy of immunoadsorption in the treatment of optic neuritis associated with neuromyelitis optica spectrum disorders

Mei Ni1, Huang Shuqi1, Chen Weimi2, Zhang Zhen2    

  1. 1 Neurology Department, Shanghai Tianyou Hospital, Shanghai 200333, China; 2 Neurology Department, Shanghai Deji Hospital, Shanghai 200333, China 
  • Received:2022-01-14 Online:2022-09-25 Published:2022-09-26

Abstract: Objective To investigate the therapeutic effect of immunoadsorption on neuromyelitis optica spectrum disease-associated optic neuritis (NMOSD-ON). Design Prospective concurrent non-randomized controlled clinical trial. Participants The data of 75 Patients with AQP4 antibody positive patients who were treated in Shanghai Deji Hospital from November 2017 to July 2020 with NMOSD-ON were collected. All patients had no obvious recovery of visual acuity after 14 days of steroid pulse therapy during acute attack. Methods 39 cases were included in the study group and 36 cases in the control group according to patients' choice. The study group was given intensive treatment with immunoadsorption therapy on the basis of hormonal pulse-decrease therapy, while the control group only continued to use steroid-pulse and post-decrease therapy. The changes of specific antibody (AQP4-IgG) titer and vision recovery in the two groups of patients before and after treatment were retrospectively analyzed. The antibody titer was detected by CBA method, and the data was statistically analyzed by SPSS25.0. Main Outcome Measures Clinical effect, visual acuity distribution, and titer changes. Results The overall effective rate of the study group was 76.92%, which was higher than the control group which was 38.89% (χ2=9.65, P=0.002). The improvement rate of visual acuity in the study group was 74.1% (43/58) , which was higher than the control group which was 17.5% (10/57) (χ2=34.81, P=0.000). The antibody titer decline rate in the study group was 94.87% (37/39), which was higher than the control group which was 30.56% (11/36) (χ2=30.88, P=0.000). Conclusion Immunoadsorption therapy can effectively reduce the specific antibody titer in patients who are not sensitive to the effect of steroid pulse therapy, and promote the recovery of vision. For acute and subacute NMOSD-ON, immunoadsorption is more effective than hormonal pulse-decrease therapy. (Ophthalmol CHN, 2022, 31: 381-385)

Key words: neuromyelitis optica spectrum disorders, optic neuritis, immunoadsorption