Neurite óptica recorrente : estudo retrospectivo descritivo e comparativo dos pacientes acompanhados no Setor de Neuroimunologia, da Disciplina de Neurologia, da Universidade Federal de São Paulo, de acordo com diagnóstico final de neuropatia óptica recorrente crônica, doenças do espectro da neuromielite óptica e esclerose múltipla
Arquivos
Data
2017
Autores
Gonçalves, Alessandra Billi Falcão 
Orientadores
Oliveira, Enedina Maria Lobato de
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
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Resumo
Objetivos: Descrever e comparar as caracteristicas dos pacientes com NO recorrente como sintoma inicial, de acordo com o diagnóstico final: Esclerose Múltipla (EM), Doenças do espectro da Neuromielite Óptica (NMOSD) ou neuropatia óptica inflamatória recorrente crônica (CRION). Métodos: Estudo retrospectivo incluindo pacientes com NO recorrente inicial do banco de dados, contendo 1823 prontuários, do setor de Neuroimunologia da Universidade Federal de São Paulo. Estes pacientes foram classificados de acordo com seu diagnóstico final em dezembro de 2016 em EM, NMOSD ou CRION e então as características clínicas, laboratoriais e achados de ressonância magnética de cada grupo foram descritas e comparadas entre si. Resultados: 33 pacientes com neurite óptica recorrente unilateral ou bilateral foram incluídos: 6 com diagnóstico final de EM, 14 com NMOSD e 13 com CRION. A maioria dos pacientes era do sexo feminino, com neurite óptica unilateral e severa no primeiro episódio. A acuidade visual no pior olho foi igual ou pior a 20/200 em 61,5% dos pacientes com CRION, 85,7% nos pacientes com NMOSD e 16,7% dos pacientes com EM. O sistema funcional visual (SFV) inicial foi maior ou igual a 5 em, respectivamente, 63,6%, 85,7% e 16,7% destes grupos. Sete pacientes soropositivos (77,8%) e três soronegativos (25,0%) apresentaram mielite transversa durante o seguimento. Conclusões: Soropositividade para anti-AQP-4, achados de RM e sistema funcional visual inicial são fatores preditivos para o diagnóstico final. NO na EM é menos grave e sua recorrência, incomum em comparação com os outros grupos. Pacientes com NMOSD e CRION comportam-se de forma semelhante mas NMOSD tende a apresentar pior acuidade visual.
Objective: To describe and compare the clinical characteristics of patients with recurrent ON as their initial symptoms, according to their final diagnosis: Multiple Sclerosis (MS), Neuromyelitis Optica Spectro Disorders (NMOSD) or chronic relapsing inflammatory optic neuropathy (CRION). Methods: Retrospective study including patients with initial recurrent ON from a database enclosed 1823 registered in Neuroimmunology Clinic of the Federal University of São Paulo. These patients were classified according to their final diagnosis in December 2016 in MS, NMOSD or CRION and then the clinical, laboratory and magnetic resonance imaging (MRI) findings characteristics of each group were noted and compared between them. Results: Thirty three patients with bilateral or unilateral recurrent ON were included: 6 with final diagnosis of MS, 14 with NMOSD and 13 with CRION. The majority of patients were female, with unilateral and severe ON in first episode. The visual acuity in worse eye was equal or less than 20/200 in 61.5% of patients with CRION, 85.7% of NMOSD and in 16.7% of those with EM. The initial VFS was five or six in, respectively, 63.6%, 85.7% and 16.7% of these groups. Seven seropositive (77.8%) and three seronegative patients (25.0%) experienced transverse myelitis episodes during the follow-up period. Conclusion: Seropositivity for anti-AQP-4 antibodies, MRI findings, and initial visual functional system score were predictive factors for the final diagnosis. ON in MS is less severe and its recurrence, unusual compared to the other groups. Patients with NMOSD and CRION behave similarly but NMOSD tends to have a worse visual acuity.
Objective: To describe and compare the clinical characteristics of patients with recurrent ON as their initial symptoms, according to their final diagnosis: Multiple Sclerosis (MS), Neuromyelitis Optica Spectro Disorders (NMOSD) or chronic relapsing inflammatory optic neuropathy (CRION). Methods: Retrospective study including patients with initial recurrent ON from a database enclosed 1823 registered in Neuroimmunology Clinic of the Federal University of São Paulo. These patients were classified according to their final diagnosis in December 2016 in MS, NMOSD or CRION and then the clinical, laboratory and magnetic resonance imaging (MRI) findings characteristics of each group were noted and compared between them. Results: Thirty three patients with bilateral or unilateral recurrent ON were included: 6 with final diagnosis of MS, 14 with NMOSD and 13 with CRION. The majority of patients were female, with unilateral and severe ON in first episode. The visual acuity in worse eye was equal or less than 20/200 in 61.5% of patients with CRION, 85.7% of NMOSD and in 16.7% of those with EM. The initial VFS was five or six in, respectively, 63.6%, 85.7% and 16.7% of these groups. Seven seropositive (77.8%) and three seronegative patients (25.0%) experienced transverse myelitis episodes during the follow-up period. Conclusion: Seropositivity for anti-AQP-4 antibodies, MRI findings, and initial visual functional system score were predictive factors for the final diagnosis. ON in MS is less severe and its recurrence, unusual compared to the other groups. Patients with NMOSD and CRION behave similarly but NMOSD tends to have a worse visual acuity.
Descrição
Citação
GONÇALVES, Alessandra Billi Falcão. Neurite óptica recorrente: estudo retrospectivo descritivo e comparativo dos pacientes acompanhados no Setor de Neuroimunologia, da Disciplina de Neurologia, da Universidade Federal de São Paulo, de acordo com diagnóstico final de neuropatia óptica recorrente crônica, doenças do espectro da neuromielite óptica e esclerose múltipla. São Paulo, 2017. [70] p. Dissertação (Mestrado em Neurologia/Neurociências) - Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, 2017.