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. 1988 Nov;51(11):1381–1386. doi: 10.1136/jnnp.51.11.1381

Autoimmune optic neuropathy: evaluation and treatment.

M J Kupersmith 1, R M Burde 1, F A Warren 1, T G Klingele 1, L P Frohman 1, H Mitnick 1
PMCID: PMC1032806  PMID: 3266235

Abstract

Fourteen patients, 12 of whom were women, with an age range from 26 to 56 years, presented with progressive or recurrent optic neuropathy, despite conventional doses of corticosteroid, and laboratory evidence of collagen vascular disease. The visual loss was severe and most had an acuity less than 20/200. Megadose corticosteroid therapy improved the vision in 11 of the 12 patients. Continued oral prednisone and cytotoxic drugs were necessary to maintain vision in nine patients. Patients with autoimmune optic neuropathy must be differentiated from cases with idiopathic optic neuritis or multiple sclerosis to facilitate the appropriate therapy.

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Selected References

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  1. April R. S., Vansonnenberg E. A case of neuromyelitis optica (Devic's syndrome) in systemic lupus erythematosus. Clinicopathologic report and review of the literature. Neurology. 1976 Nov;26(11):1066–1070. doi: 10.1212/wnl.26.11.1066. [DOI] [PubMed] [Google Scholar]
  2. Austin H. A., 3rd, Klippel J. H., Balow J. E., le Riche N. G., Steinberg A. D., Plotz P. H., Decker J. L. Therapy of lupus nephritis. Controlled trial of prednisone and cytotoxic drugs. N Engl J Med. 1986 Mar 6;314(10):614–619. doi: 10.1056/NEJM198603063141004. [DOI] [PubMed] [Google Scholar]
  3. Baker G. L., Kahl L. E., Zee B. C., Stolzer B. L., Agarwal A. K., Medsger T. A., Jr Malignancy following treatment of rheumatoid arthritis with cyclophosphamide. Long-term case-control follow-up study. Am J Med. 1987 Jul;83(1):1–9. doi: 10.1016/0002-9343(87)90490-6. [DOI] [PubMed] [Google Scholar]
  4. Dasgupta M. K., Warren K. G., Johny K. V., Dossetor J. B. Circulating immune complexes in multiple sclerosis: relation with disease activity. Neurology. 1982 Sep;32(9):1000–1004. doi: 10.1212/wnl.32.9.1000. [DOI] [PubMed] [Google Scholar]
  5. Dore-Duffy P., Donaldson J. O., Rothman B. L., Zurier R. B. Antinuclear antibodies in multiple sclerosis. Arch Neurol. 1982 Aug;39(8):504–506. doi: 10.1001/archneur.1982.00510200046008. [DOI] [PubMed] [Google Scholar]
  6. Dowling P. C., Cook S. D. Disease markers in acute multiple sclerosis. Arch Neurol. 1976 Oct;33(10):668–667. doi: 10.1001/archneur.1976.00500100002003. [DOI] [PubMed] [Google Scholar]
  7. Estes D., Christian C. L. The natural history of systemic lupus erythematosus by prospective analysis. Medicine (Baltimore) 1971 Mar;50(2):85–95. doi: 10.1097/00005792-197103000-00001. [DOI] [PubMed] [Google Scholar]
  8. Fauci A. S., Dale D. C., Balow J. E. Glucocorticosteroid therapy: mechanisms of action and clinical considerations. Ann Intern Med. 1976 Mar;84(3):304–315. doi: 10.7326/0003-4819-84-3-304. [DOI] [PubMed] [Google Scholar]
  9. Fulford K. W., Catterall R. D., Delhanty J. J., Doniach D., Kremer M. A collagen disorder of the nervous system presenting as multiple sclerosis. Brain. 1972;95(2):373–386. doi: 10.1093/brain/95.2.373. [DOI] [PubMed] [Google Scholar]
  10. Gold D. H., Morris D. A., Henkind P. Ocular findings in systemic lupus erythematosus. Br J Ophthalmol. 1972 Nov;56(11):800–804. doi: 10.1136/bjo.56.11.800. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Gressel M. G., Tomsak R. L. Recurrent bilateral optic neuropathy in mixed connective tissue disease. J Clin Neuroophthalmol. 1983 Jun;3(2):101–104. [PubMed] [Google Scholar]
  12. HOLLENHORST R. W., HENDERSON J. W. The ocular manifestations of the diffuse collagen diseases. Am J Med Sci. 1951 Feb;221(2):211–222. [PubMed] [Google Scholar]
  13. Hackett E. R., Martinez R. D., Larson P. F., Paddison R. M. Optic neuritis in systemic lupus erythematosus. Arch Neurol. 1974 Jul;31(1):9–11. doi: 10.1001/archneur.1974.00490370035002. [DOI] [PubMed] [Google Scholar]
  14. Hauser S. L., Dawson D. M., Lehrich J. R., Beal M. F., Kevy S. V., Propper R. D., Mills J. A., Weiner H. L. Intensive immunosuppression in progressive multiple sclerosis. A randomized, three-arm study of high-dose intravenous cyclophosphamide, plasma exchange, and ACTH. N Engl J Med. 1983 Jan 27;308(4):173–180. doi: 10.1056/NEJM198301273080401. [DOI] [PubMed] [Google Scholar]
  15. Jabs D. A., Miller N. R., Newman S. A., Johnson M. A., Stevens M. B. Optic neuropathy in systemic lupus erythematosus. Arch Ophthalmol. 1986 Apr;104(4):564–568. doi: 10.1001/archopht.1986.01050160120026. [DOI] [PubMed] [Google Scholar]
  16. Johnson R. T., Richardson E. P. The neurological manifestations of systemic lupus erythematosus. Medicine (Baltimore) 1968 Jul;47(4):337–369. doi: 10.1097/00005792-196807000-00002. [DOI] [PubMed] [Google Scholar]
  17. Kinney E. L., Berdoff R. L., Rao N. S., Fox L. M. Devic's syndrome and systemic lupus erythematosus: a case report with necropsy. Arch Neurol. 1979 Oct;36(10):643–644. doi: 10.1001/archneur.1979.00500460077012. [DOI] [PubMed] [Google Scholar]
  18. Lessell S. The neuro-ophthalmology of systemic lupus erythematosus. Doc Ophthalmol. 1979 Sep 17;47(1):13–42. doi: 10.1007/BF00145368. [DOI] [PubMed] [Google Scholar]
  19. Mertin J., Knight S. C., Rudge P., Thompson E. J., Healy M. J. Double-blind, controlled trial of immunosuppression in treatment of multiple sclerosis. Lancet. 1980 Nov 1;2(8201):949–951. doi: 10.1016/s0140-6736(80)92107-8. [DOI] [PubMed] [Google Scholar]
  20. Miller D. H., Ormerod I. E., Gibson A., du Boulay E. P., Rudge P., McDonald W. I. MR brain scanning in patients with vasculitis: differentiation from multiple sclerosis. Neuroradiology. 1987;29(3):226–231. doi: 10.1007/BF00451758. [DOI] [PubMed] [Google Scholar]
  21. Myers L. W., Fahey J. L., Moody D. J., Mickey M. R., Frane M. V., Ellison G. W. Cyclophosphamide 'pulses' in chronic progressive multiple sclerosis. A preliminary clinical trial. Arch Neurol. 1987 Aug;44(8):828–832. doi: 10.1001/archneur.1987.00520200032014. [DOI] [PubMed] [Google Scholar]
  22. Nordal G. J., Vandvik B. Evidence of local synthesis of smooth-muscle antibodies in the central nervous system in isolated cases of multiple sclerosis and chronic lymphocytic meningoencephalitis. Scand J Immunol. 1977;6(4):327–334. doi: 10.1111/j.1365-3083.1977.tb00401.x. [DOI] [PubMed] [Google Scholar]
  23. Ormerod I. E., McDonald W. I. Multiple sclerosis presenting with progressive visual failure. J Neurol Neurosurg Psychiatry. 1984 Sep;47(9):943–946. doi: 10.1136/jnnp.47.9.943. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Rush J. A., Kennerdell J. S., Martinez A. J. Primary idiopathic inflammation of the optic nerve. Am J Ophthalmol. 1982 Mar;93(3):312–316. doi: 10.1016/0002-9394(82)90531-1. [DOI] [PubMed] [Google Scholar]
  25. SIEKERT R. G., CLARK E. C. Neurologic signs and symptoms as early manifestations of systemic lupus erythematosus. Neurology. 1955 Feb;5(2):84–88. doi: 10.1212/wnl.5.2.84. [DOI] [PubMed] [Google Scholar]
  26. Tachovsky T. G., Lisak R. P., Koprowski H., Theofilopoulos A. N., Dixon F. J. Circulating immune complexes in multiple sclerosis and other neurological diseases. Lancet. 1976 Nov 6;2(7993):997–999. doi: 10.1016/s0140-6736(76)90835-7. [DOI] [PubMed] [Google Scholar]
  27. Van Buskirk E. M. Reopening filtration fistulas with the argon laser. Am J Ophthalmol. 1982 Jul;94(1):1–3. doi: 10.1016/0002-9394(82)90182-9. [DOI] [PubMed] [Google Scholar]
  28. Whitaker J. N., Dowling P. C., Cook S. D. Immunofluorescent studies of the kidney in human neurologic disorders. J Neuropathol Exp Neurol. 1971 Jan;30(1):129–130. [PubMed] [Google Scholar]

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