Objective: To compare the effects of different treatment and prevention regimens on recovery and relapse rate in patients with myelin oligodendrocyte glycoprotein antibody-related optic neuritis (MOG-ON). Methods: Retrospective study of the records of 37 patients with MOG-ON in ZhongShan Ophthalmology Center from January 2014 to December 2018. Patients with first-ever MOG-ON (first-ever group) were subdivided into intravenous methylprednisolone pulse group (Pulse group) and high dose methylprednisolone without pulse regimen group (non-pulse group). Comparisons were taken on visual acuity (VA), visual field (VF), visual evoked potential amplitude (VEP) and retinal nerve fiber layer thickness (RNFLT). Effect of different prevention regimens, either low dose prednisone or low dose of prednisone (2.5-10 mg/Day) combined with mycophenolate mofetil (MMF) (0.5-1 g/Day) , as well as the annual relapse rate (ARR) were compared. Results: Among 25 patients of first-ever MOG-ON group (19 patients in pulse group and 6 patients in non-pulse group), VF of pulse group showed significant recovery, with MD value of (-7±8) dB at 1 m after onset and (-26±11) dB at onset (P<0.01), while non-pulse group showed significant VF recovery only at 6 m after onset, with MD value of (-9±9) dB at 6 m and (-22±11) dB at onset (P<0.01). However, no significant difference of VA, VF, VEP and RNFL could be found between the two groups on at all follow-up time points (P>0.05). Among 12 patients with at least one relapse (relapse group), 9 patients (75%) were given low-dose of prednisone plus MMF for relapse prevention. The ARR was 0.77 (0.21-4.5) before and 0 (0-0.41) after the regimen, respectively (P<0.05). Conclusion: Intravenous methylprednisolone pulse therapy in acute phase of MOG-ON may accelerate the recovery of visual function and improve the prognosis. Low-dose of prednisone combined with MMF may reduce the recurrence rate of MOG-ON.
目的： 回顾分析不同治疗及预防方案对髓鞘少突胶质细胞糖蛋白抗体相关视神经炎（MOG-ON）患者急性期治疗效果及复发率的影响。 方法： 收集2014年1月至2018年12月，在中山大学中山眼科中心确诊MOG-ON患者37例。比较激素冲击治疗及大剂量激素（未冲击）治疗对首次发作的MOG-ON患者（初发组）视功能恢复及视网膜神经纤维层厚度影响；比较小剂量激素及小剂量激素联合吗替麦考酚酯（MMF）预防方案，对MOG-ON复发率的影响。 结果： 37例MOG-ON患者中，初发组25例，复发组12例。初发组，采用激素冲击治疗19例，大剂量激素（未冲击）组6例。激素冲击组治疗后1个月视野MD值[（-7±8）dB]较发病时[（-26±11）dB]有显著恢复（P<0.01），而大剂量激素（未冲击）组治疗后6个月视野MD值[（-9±9）dB]才较发病时[（-22±11）dB]有显著恢复（P<0.01）。两组最佳矫正视力、视野缺损、视诱发电位振幅、视网膜神经纤维层厚度在发病后1、3、6个月差异均无统计学意义（P>0.05）。在复发预防中，复发组小剂量激素联合MMF预防9例（75%），预防前年复发率为0.77（0.21~4.5）次/年，预防后仅一例复发，年复发率降低为0（0~0.41）次/年（P<0.05）。 结论： MOG-ON急性期激素冲击治疗有可能加快视功能恢复及改善预后，小剂量激素联合MMF方案有可能降低MOG-ON复发率。.
Keywords: Myelin oligodendrocyte glycoprotein antibody related optic neuritis; Prevention; Treatment.