title: Lesion length of optic neuritis impacts visual prognosis in neuromyelitis optica.
abstract: OBJECTIVE
  The visual acuity prognoses of patients with neuromyelitis optica (NMO) are worse than those with optic neuritis (ON) caused by other diseases. Predicting the prognoses of ON at the time of onset is important for selecting treatments for NMO patients.
  
  
  METHODS
  Twenty-three consecutive anti-aquaporin-4 autoantibody-positive NMO patients who presented with ON and had contrast-enhanced optic MRIs in the acute phase of their first ON episode were examined. Optical coherence tomographies (OCTs) were also examined for 22 of them. The visual acuity at the final follow-up, as assessed with the logMAR scale more than three years after ON onset, served as the outcome measure. These variables were also collected from 12 patients with serum anti-myelin oligodendrocyte glycoprotein antibody (anti-MOG-Ab).
  
  
  RESULTS
  The strongest predictor of visual prognosis was the axial ON lesion length in the acute phase (R=0.747, p<0.0001), which was not observed in patients with anti-MOG-Ab. Specifically, the ON lesion length within the intra-orbit and canalicular segments exhibited the strongest correlation with visual prognosis (R=0.783, p<0.0001). The ON onset age was also correlated with visual prognosis (R=0.435, p=0.0338). OCT data in the chronic phase also showed a correlation with visual prognosis, but they were much weaker than the ON lesion length in the acute phase.
  
  
  CONCLUSIONS
  The ON lesion length in the acute phase was an important predictor of the visual prognoses of NMO patients.
authors.affiliation: Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan. Electronic address: t-akaishi@med.tohoku.ac.jp.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Akaishi
authors.affiliation: Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan. Electronic address: nakashima@med.tohoku.ac.jp.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Nakashima
authors.affiliation: Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan. Electronic address: takeshita.oph@me.com.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Takeshita
authors.affiliation: Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan. Electronic address: mugi844@gmail.com.
authors.forename: Shunji
authors.initials: S
authors.lastname: Mugikura
authors.affiliation: Department of Multiple Sclerosis Therapeutics, Tohoku University Graduate School of Medicine, Sendai, Japan. Electronic address: douglas.sato@med.tohoku.ac.jp.
authors.forename: Douglas Kazutoshi
authors.initials: DK
authors.lastname: Sato
authors.affiliation: Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Neurology, Yonezawa National Hospital, Yonezawa, Japan. Electronic address: t-toshiyuki@mta.biglobe.ne.jp.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Takahashi
authors.affiliation: Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan. Electronic address: snishym@med.tohoku.ac.jp.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Nishiyama
authors.affiliation: Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan. Electronic address: kaizaahige@gmail.com.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kurosawa
authors.affiliation: Department of Multiple Sclerosis Therapeutics, Tohoku University Graduate School of Medicine, Sendai, Japan. Electronic address: misu@med.tohoku.ac.jp.
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Misu
authors.affiliation: Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan. Electronic address: ntoru@oph.med.tohoku.ac.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Nakazawa
authors.affiliation: Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan. Electronic address: aokim@med.tohoku.ac.jp.
authors.forename: Masashi
authors.initials: M
authors.lastname: Aoki
authors.affiliation: Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Multiple Sclerosis Therapeutics, Tohoku University Graduate School of Medicine, Sendai, Japan. Electronic address: fujikazu@med.tohoku.ac.jp.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Fujihara
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D051401:Aquaporin 4 / Q000276:immunology; D001323:Autoantibodies / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D063308:Myelin-Oligodendrocyte Glycoprotein / Q000276:immunology; D009471:Neuromyelitis Optica / Q000276:immunology / Q000473:pathology* / Q000503:physiopathology*; D009902:Optic Neuritis / Q000473:pathology*; D011379:Prognosis; D012160:Retina / Q000473:pathology*; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology; D014795:Visual Pathways / Q000473:pathology; D055815:Young Adult
chemical_list: D051401:Aquaporin 4; D001323:Autoantibodies; D063308:Myelin-Oligodendrocyte Glycoprotein
keywords: Neuromyelitis optica; Optic MRI; Optic coherence tomography; Optic neuritis; Visual prognosis