The patients' blood samples were tested for the presence of anti‐aquaporin‐4 (AQP4) antibodies using the commercially available enzyme‐linked immunosorbent assay (ELISA) from RSR Limited (performed at Aarhus University). Previously healthy patients with abnormal MRI also had a lumbar puncture to measure the IgG‐index and rule out neuroinfection. Neurological and paraclinical evaluationĪt inclusion, all patients had a full neurological examination and a magnetic resonance imaging (MRI) of the brain and spinal cord. The objectives of this prospective study were to identify, examine, and follow‐up for a 1‐year period, new cases of acute ON in the Central Region of Denmark and to evaluate the effect of early onset steroid treatment in patients with severe ON.Ģ.2. However, the time of initiation of treatment after symptom presentation may be important for the effect, for instance, the earlier the treatment is initiated there may be a chance for protecting visual function and retinal cell layers (Nakamura et al., 2010 Plant, Sibtain, & Thomas, 2011). Optic neuritis has several pathophysiological similarities with MS (Frohman et al., 2008), and treatment with high doses of methylprednisolone (steroid) has been shown to alleviate symptoms and accelerate recovery in both disorders (Beck et al., 1992 Brusaferri & Candelise, 2000 Miller et al., 2000). ON can cause axonal loss in the optic nerve, which can be visualized using optical coherence tomography (OCT) scanning and is seen as reduced thickness of the retinal nerve fiber (RNFL) and ganglion cell layer (GCL) (Costello et al., 2006, 2008 Syc et al., 2012). The prognosis for visual recovery is generally good but contrast sensitivity and color vision are rarely normal, especially in patients with MS (Beck et al., 2004 Cole, Beck, Moke, Gal, & Long, 2000 Fleishman, Beck, Linares, & Klein, 1987). ON is often associated with demyelinating disorders such as multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) (Jarius, Wildemann, & Paul, 2014 Oertel et al., 2017). Optic neuritis (ON) is characterized by subacute monocular visual loss, impaired color vision and periocular pain that worsens during eye movement (Galetta et al., 2015 Petzold & Plant, 2014).
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