Analysis of the relationship between AQP4-IgG expression and clinical characteristics in patients with demyelinated optic neuritis in western China

Abstract:

Objective To compare the relationship between AQP4-IgG expression and its clinical characteristics in the serum or cerebrospinal fluid of 142 patients with demyelinated optic neuritis（DON）.Methods We retrospectively collected and analyzed the clinical data and AQP4-IgG results of 142 DON patients admitted to the Department of Ophthalmology of The First Affiliated Hospital of Army Medical University from January 2016 to October 2020.Results ①AQP4-IgG positive was detected in 48 cases（33.8%），the female to male ratio was 5.9∶1，and 31 cases（64.6%） involved both eyes. The LogMAR visual acuity at the first visit was 0.48±0.64，and was 0.55±0.65 at the last visit. ②AQP4-IgG negative was detected in 94 cases（66.2%），the female to male ratio was 1.7∶1，and 53 cases（56.4%）involved both eyes. The LogMAR visual acuity at the first visit was 0.54±0.61，and was 0.39±0.49 at the last visit. ③The proportion of AQP4-IgG-positive female patients was significantly higher than that of AQP4-IgG-negative patients（χ2=7.827，P<0.01）； there was no statistical difference in the prevalence of both eyes（χ2=0.884，P>0.05）； there was no significant difference in LogMAR visual acuity at the time of onset（t=-0.721，P>0.05），but AQP4-IgG positive patients had worse visual prognosis（t=2.058，P<0.05）. AQP4-IgG positive patients had higher erythrocyte sedimentation rate（χ2=5.403，P<0.05）and a higher proportion of combined autoantibody results than AQP4-IgG negative patients（χ2=5.231，P<0.05），both of which had significant differences.Conclusion AQP4-IgG-positive patients with neuromyelitis optica spectrum disorders have a higher incidence of female morbidity，with worse visual prognosis，and may be combined with abnormal autoantibody results or autoimmune diseases. Accurate clinical classification based on AQP4-IgG detection is important for the treatment and prognosis.