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Optic neuritis treatment trial

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https://www.readbyqxmd.com/read/30095536/initial-impairment-and-recovery-of-vision-related-functioning-in-participants-with-acute-optic-neuritis-from-the-renew-trial-of-opicinumab
#1
Jennifer Petrillo, Laura Balcer, Steven Galetta, Yi Chai, Lei Xu, Diego Cadavid
BACKGROUND: Leucine-rich repeat and immunoglobulin domain-containing Nogo receptor-interacting protein 1(LINGO-1 is a key suppressor of oligodendrocyte differentiation and axonal remyelination and regeneration. This analysis evaluated the potential benefit of opicinumab, a human monoclonal antibody against LINGO-1, vs placebo on exploratory clinical endpoints of patient-reported vision-related functioning and high-contrast visual acuity (HCVA) in RENEW participants with acute optic neuritis (AON)...
August 7, 2018: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/29693233/management-of-optic-neuritis-in-ireland-a-survey-comparing-the-management-practices-of-acute-demyelinating-optic-neuritis-amongst-ophthalmologists-and-neurologists-in-ireland
#2
Lina Kobayter, Shivona Chetty
BACKGROUND: Acute optic neuritis (ON) is often the first manifestation of multiple sclerosis which is particularly common in Ireland. Despite the specific clinical details regarding investigations and management of ON provided by the Optic Neuritis Treatment Trial (ONTT), international surveys have shown that there are still notable differences in the management of ON between neurologists and ophthalmologists. AIM: To compare the investigation and treatment of acute optic neuritis between ophthalmologists and neurologists in Ireland METHOD: A survey consisting of a case scenario and questions regarding treatment and investigations of a patient with ON was emailed to ophthalmology consultants, trainees and medical ophthalmologists registered with the Irish College of Ophthalmologists and to neurology consultants and registrars registered with the Irish Institute of Clinical Neuroscience...
April 24, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29667789/updates-and-controversies-in-the-management-of-acute-optic-neuritis
#3
Ethan Meltzer, Sashank Prasad
Optic neuritis remains a common diagnosis with controversial management. Although typical optic neuritis is often associated with "good" recovery of visual acuity, patients are often left with persistent impairments of contrast sensitivity, color vision, and visual field. These permanent visual deficits correlate with structural injury to the anterior visual pathway and are closely linked to visual quality of life. High dose corticosteroids are commonly used for patients with acute optic neuritis...
April 18, 2018: Asia-Pacific Journal of Ophthalmology
https://www.readbyqxmd.com/read/29554001/visual-outcomes-and-clinical-manifestations-of-pediatric-optic-neuritis-in-indian-population-an-institutional-study
#4
Selvakumar Ambika, Krishnakumar Padmalakshmi, Viswanathan Venkatraman, Olma V Noronha
BACKGROUND: Optic neuritis in children is an uncommon disorder which usually occurs after a viral illness or vaccination and, less frequently, occurs as a manifestation of a demyelinating disorder. Pediatric optic neuritis usually is bilateral and presents with optic disc edema, recovers rapidly with steroid therapy, and generally has low conversion rate to multiple sclerosis or neuromyelitis optica spectrum disorder. We report the clinical features and treatment outcomes of pediatric optic neuritis in Indian population, for which little data are available...
March 16, 2018: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/29527473/fibre-specific-white-matter-changes-in-multiple-sclerosis-patients-with-optic-neuritis
#5
Sanuji Gajamange, David Raffelt, Thijs Dhollander, Elaine Lui, Anneke van der Walt, Trevor Kilpatrick, Joanne Fielding, Alan Connelly, Scott Kolbe
Long term irreversible disability in multiple sclerosis (MS) is thought to be primarily driven by axonal degeneration. Axonal degeneration leads to degenerative atrophy, therefore early markers of axonal degeneration are required to predict clinical disability and treatment efficacy. Given that additional pathologies such as inflammation, demyelination and oedema are also present in MS, it is essential to develop axonal markers that are not confounded by these processes. The present study investigated a novel method for measuring axonal degeneration in MS based on high angular resolution diffusion magnetic resonance imaging...
2018: NeuroImage: Clinical
https://www.readbyqxmd.com/read/29514678/early-alpha-lipoic-acid-therapy-protects-from-degeneration-of-the-inner-retinal-layers-and-vision-loss-in-an-experimental-autoimmune-encephalomyelitis-optic-neuritis-model
#6
Michael Dietrich, Niklas Helling, Alexander Hilla, Annemarie Heskamp, Andrea Issberner, Thomas Hildebrandt, Zippora Kohne, Patrick Küry, Carsten Berndt, Orhan Aktas, Dietmar Fischer, Hans-Peter Hartung, Philipp Albrecht
BACKGROUND: In multiple sclerosis (MS), neurodegeneration is the main reason for chronic disability. Alpha-lipoic acid (LA) is a naturally occurring antioxidant which has recently been demonstrated to reduce the rate of brain atrophy in progressive MS. However, it remains uncertain if it is also beneficial in the early, more inflammatory-driven phases. As clinical studies are costly and time consuming, optic neuritis (ON) is often used for investigating neuroprotective or regenerative therapeutics...
March 7, 2018: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29507942/effect-of-treating-acute-optic-neuritis-with-bioequivalent-oral-vs-intravenous-corticosteroids-a-randomized-clinical-trial
#7
Sarah A Morrow, J Alexander Fraser, Chad Day, Denise Bowman, Heather Rosehart, Marcelo Kremenchutzky, Michael Nicolle
Importance: Intravenous (IV) administration of corticosteroids is the standard of care in the treatment of acute optic neuritis. However, it is uncertain whether a bioequivalent dose of corticosteroid administered orally, which may be more cost-efficient and convenient for patients, is as effective as IV administration in the treatment of acute optic neuritis. Objective: To determine whether recovery of vision following treatment of acute optic neuritis with a high-dose IV corticosteroid is superior to that with a bioequivalent dose of an oral corticosteroid...
June 1, 2018: JAMA Neurology
https://www.readbyqxmd.com/read/29470571/prevalence-of-myelin-oligodendrocyte-glycoprotein-and-aquaporin-4-igg-in-patients-in-the-optic-neuritis-treatment-trial
#8
John J Chen, W Oliver Tobin, Masoud Majed, Jiraporn Jitprapaikulsan, James P Fryer, Jacqueline A Leavitt, Eoin P Flanagan, Andrew McKeon, Sean J Pittock
Importance: Autoantibodies to aquaporin-4 (AQP4) and myelin oligodendrocyte glycoprotein (MOG) are recently established biomarkers of autoimmune optic neuritis whose frequency and accompanying phenotype, especially for MOG-IgG, are still being characterized. The Optic Neuritis Treatment Trial (ONTT) was a well-known randomized clinical trial in optic neuritis; therefore, knowledge of the serostatus and accompanying phenotype of these patients would be useful to determine the frequency of these antibodies in patients presenting with typical monocular optic neuritis and their outcomes...
April 1, 2018: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28497312/phenytoin-neuroprotection-or-neurotoxicity
#9
REVIEW
Jan M Keppel Hesselink, David J Kopsky
Phenytoin is an 80-year young molecule and new indications are still emerging. The neuroprotective potential of phenytoin has been evaluated for decades. Recently, a positive phase II trial supported its further development in the treatment of optic neuritis in multiple sclerosis. In 1942, however, peripheral neuritis was first reported to be an adverse event of phenytoin, and since then a small but steady stream of publications discussed peripheral polyneuropathy as being a possible adverse event of phenytoin...
June 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28289949/clinical-characteristics-of-optic-neuritis-in-hong-kong-population-10-year-review
#10
Bonnie Nga Kwan Choy, Alex Lap Ki Ng, Jimmy Shiu Ming Lai
PURPOSE: To review the clinical course of adult patients with acute optic neuritis over 10 years in Hong Kong, and the results were compared with other studies among Asian and Caucasian patients. METHODS: This study retrospectively analysed the clinical features of 38 adult patients (51 eyes) presented with optic neuritis in a Hong Kong hospital over 10 years (2001-2010). RESULTS: Optic neuritis had a female predominance (68%). The mean age of presentation was 40 years old...
April 2018: International Ophthalmology
https://www.readbyqxmd.com/read/28229892/safety-and-efficacy-of-opicinumab-in-acute-optic-neuritis-renew-a-randomised-placebo-controlled-phase-2-trial
#11
RANDOMIZED CONTROLLED TRIAL
Diego Cadavid, Laura Balcer, Steven Galetta, Orhan Aktas, Tjalf Ziemssen, Ludo Vanopdenbosch, Jette Frederiksen, Mark Skeen, Glenn J Jaffe, Helmut Butzkueven, Focke Ziemssen, Luca Massacesi, Yi Chai, Lei Xu, Stefanie Freeman
BACKGROUND: The human monoclonal antibody opicinumab (BIIB033, anti-LINGO-1) has shown remyelinating activity in preclinical studies. We therefore assessed the safety and tolerability, and efficacy of opicinumab given soon after a first acute optic neuritis episode. METHODS: This randomised, double-blind, placebo-controlled, phase 2 study (RENEW) was done at 33 sites in Australia, Canada, and Europe in participants (aged 18-55 years) with a first unilateral acute optic neuritis episode within 28 days from study baseline...
March 2017: Lancet Neurology
https://www.readbyqxmd.com/read/27941524/neuroprotection-and-visual-function-after-optic-neuritis
#12
REVIEW
Axel Petzold
PURPOSE OF REVIEW: This article discusses the advantages and pitfalls of testing neuroprotective treatment strategies in patients suffering from optic neuritis. RECENT FINDINGS: Spectral domain optical coherence tomography now permits for automated segmentation of individual retinal layers. The peripapillary retinal nerve fibre layer (pRNFL) has been used in 13 of the 15 trials reviewed. Twelve trials also made use of electrophysiology. Overestimation of good visual recovery in the past has recently been recognized...
February 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/27787712/optic-nerve
#13
Lynn K Gordon
Optic nerve diseases arise from many different etiologies including inflammatory, neoplastic, genetic, infectious, ischemic, and idiopathic. Understanding some of the characteristics of the most common optic neuropathies along with therapeutic approaches to these diseases is helpful in designing recommendations for individual patients. Although many optic neuropathies have no specific treatment, some do, and it is those potentially treatable or preventable conditions which need to be recognized in order to help patients regain their sight or develop a better understanding of their own prognosis...
2017: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/27572862/pediatric-optic-neuritis
#14
REVIEW
E Ann Yeh, Jennifer S Graves, Leslie A Benson, Evangeline Wassmer, Amy Waldman
Optic neuritis (ON) is a common presenting symptom in pediatric CNS demyelinating disorders and may be associated with dramatic visual loss. Knowledge regarding clinical presentation, associated diseases, therapy, and outcomes in ON in children has grown over the past decade. These studies have shown that younger children (<10 years of age) are more likely to present with bilateral ON and older children with unilateral ON. Furthermore, studies focusing on visual recovery have shown excellent recovery of high-contrast visual acuity in the majority of children, but functional and structural studies have shown evidence of irreversible injury and functional decline after ON in children...
August 30, 2016: Neurology
https://www.readbyqxmd.com/read/27402111/neuromyelitis-optica-devic-s-syndrome-an-appraisal
#15
REVIEW
Teresa M Crout, Laura P Parks, Vikas Majithia
Neuromyelitis optica (NMO) and neuromyelitis optica spectrum disorders (NMOSD), previously known as Devic's syndrome, are a group of inflammatory disorders of the central nervous system (CNS) characterized by severe, immune-mediated demyelination and axonal damage, predominantly targeting optic nerves and the spinal cord typically associated with a disease-specific serum NMO-IgG antibody that selectively binds aquaporin-4 (AQP4). The classic and best-defined features of NMOSD include acute attacks of bilateral or rapidly sequential optic neuritis (leading to visual loss) or transverse myelitis (often causing limb weakness and bladder dysfunction) or both with a typically relapsing course...
August 2016: Current Rheumatology Reports
https://www.readbyqxmd.com/read/27285322/revisiting-the-role-of-erythropoietin-for-treatment-of-ocular-disorders
#16
REVIEW
S L Shirley Ding, S N Leow, R Munisvaradass, E H Koh, M L C Bastion, K Y Then, S Kumar, P L Mok
Erythropoietin (EPO) is a glycoprotein hormone conventionally thought to be responsible only in producing red blood cells in our body. However, with the discovery of the presence of EPO and EPO receptors in the retinal layers, the EPO seems to have physiological roles in the eye. In this review, we revisit the role of EPO in the eye. We look into the biological role of EPO in the development of the eye and the physiologic roles that it has. Apart from that, we seek to understand the mechanisms and pathways of EPO that contributes to the therapeutic and pathological conditions of the various ocular disorders such as diabetic retinopathy, retinopathy of prematurity, glaucoma, age-related macular degeneration, optic neuritis, and retinal detachment...
October 2016: Eye
https://www.readbyqxmd.com/read/27238905/ophthalmologic-aspects-of-chikungunya-infection
#17
REVIEW
Dayron F Martínez-Pulgarín, Fazle Rabbi Chowdhury, Wilmer E Villamil-Gomez, Alfonso J Rodriguez-Morales, Gabriela M Blohm, Alberto E Paniz-Mondolfi
Chikungunya fever, a viral disease epidemic in some parts of the world is newly introduced in the Americas. This is of considerable international concern, with a growing incidence owing to developing urbanization, tourism, and trade. Ocular manifestations of chikungunya fever are not frequent, but of great relevance. Common manifestations include conjunctivitis, optic neuritis, iridocyclitis, episcleritis, retinitis and uveitis. Diagnostic and monitoring investigations would include optical coherence tomography, fundus fluorescein and indocyanine green angiography, visual field analysis, and electrophysiologic tests...
September 2016: Travel Medicine and Infectious Disease
https://www.readbyqxmd.com/read/27237752/neuromyelitis-optica-relapses-race-and-rate-immunosuppression-and-impairment
#18
George Tackley, Fanny O'Brien, João Rocha, Mark Woodhall, Patrick Waters, Saleel Chandratre, Christopher Halfpenny, Cheryl Hemingway, Evangeline Wassmer, Warren Wasiewski, Maria Isabel Leite, Jacqueline Palace
OBJECTIVE: Neuromyelitis optica (NMO) is a rare antibody-mediated CNS disease characterised by disabling relapses leading to high morbidity and mortality. Understanding relapse activity and severity is important for treatment decisions and clinical trial design. We assessed (1) whether clinical and demographic factors associate with different relapse rates and (2) the relative impact of immunosuppressive treatments on relapse rates and on attack-related residual disability. METHODS: Clinical, demographic and treatment data were prospectively collected from 79 consecutive aquaporin 4 antibody positive patients seen in the nationally commissioned Oxford NMO service...
May 2016: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/27165274/-immunomodulation-and-neuroprotection-in-optic-neuritis
#19
REVIEW
F Beisse, R Diem
BACKGROUND: To date, high-dose corticosteroids constitute the only established treatment of acute optic neuritis (ON); however, steroids cannot prevent the loss of retinal nerve fibers. New acute therapeutic drugs are therefore being sought for a reduction of ganglion cell death. METHODS: Literature search comprising clinical studies on treatment of ON with immunomodulatory and neuroprotective drugs. RESULTS: For the immunomodulatory drug simvastatin some evidence for long-term benefits was shown, particularly regarding visual evoked potentials...
May 2016: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/26932144/treatment-of-optic-neuritis-with-erythropoietin-tone-a-randomised-double-blind-placebo-controlled-trial-study-protocol
#20
RANDOMIZED CONTROLLED TRIAL
Ricarda Diem, Fanni Molnar, Flemming Beisse, Nikolai Gross, Katharina Drüschler, Sven P Heinrich, Lutz Joachimsen, Sebastian Rauer, Amelie Pielen, Kurt-Wolfram Sühs, Ralf Andreas Linker, Cord Huchzermeyer, Philipp Albrecht, Andrea Hassenstein, Orhan Aktas, Tanja Guthoff, Felix Tonagel, Christoph Kernstock, Kathrin Hartmann, Tania Kümpfel, Katharina Hein, Christian van Oterendorp, Birgit Grotejohann, Gabriele Ihorst, Julia Maurer, Matthias Müller, Martin Volkmann, Brigitte Wildemann, Michael Platten, Wolfgang Wick, Christoph Heesen, Ulrich Schiefer, Sebastian Wolf, Wolf A Lagrèze
INTRODUCTION: Optic neuritis leads to degeneration of retinal ganglion cells whose axons form the optic nerve. The standard treatment is a methylprednisolone pulse therapy. This treatment slightly shortens the time of recovery but does not prevent neurodegeneration and persistent visual impairment. In a phase II trial performed in preparation of this study, we have shown that erythropoietin protects global retinal nerve fibre layer thickness (RNFLT-G) in acute optic neuritis; however, the preparatory trial was not powered to show effects on visual function...
March 1, 2016: BMJ Open
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