INFLUENCE OF PREGNANCY ON NEUROMYELITIS OPTICA FROM AN OPHTHALMOLOGICAL POINT OF VIEW. A CASE REPORT

Stáhnout PDF English version

Autoři: F. Aslan ¹; M. Tuğba-Çimşir ²; E. Özdemir-Öktem ³
Působiště autorů: Alaaddin Keykubat University Alanya Education and Research, Hospital, Department of Ophthalmology Antalya, Turkey ¹; Alaaddin Keykubat University Alanya Education and Research, Hospital, Department of Obstetrics and Gynaecology Antalya, Turkey ²; Alaaddin Keykubat University Alanya Education and Research, Hospital, Department of Neurology Antalya, Turkey ³
Vyšlo v časopise: Čes. a slov. Oftal., 78, 2022, No. 1, p. 31-34
Kategorie: Kazuistika
doi: https://doi.org/10.31348/2022/6

Souhrn

Neuromyelitis Optica (NMO, Devic’s disease) is a rare demyelinating disease of the central nervous system, leading to optic neuritis and transverse myelitis. The clinical course of the disease and ocular changes in pregnancy are still not well known. Here we present the subclinical ophthalmological changes which were evaluated by spectral domain optical coherence tomography (SD-OCT) during the 39 weeks’ gestation and postpartum period in a pregnant woman with a diagnosis of NMO. In addition, we present the obstetric and neurological course of our patient and review the literature. A 30-year-old female with a history of NMO was ophthalmologically examined and SD-OCT was performed periodically every trimester to observe the effects of pregnancy on the disease course. No ophthalmological changes were observed during the pregnancy and postpartum period. Caesarean delivery was preferred due to obstetric indication. The patient was discharged on the second day of the postpartum period.

Zdroje

1. Wingerchuk DM, Weinshenker BG. Neuromyelitis optica: clinical predictors of a relapsing course and survival. Neurology. 2003 Mar;60(5):848-853.

2. Wingerchuk DM, Banwell B, Bennett JL, et al. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology. 2015 Jul;85(2):177-189.

3. Papadopoulos MC, Verkman AS. Aquaporin 4 and neuromyelitis optica. Lancet Neurol. 2012 Jun;11(6):535-544.

4. Wingerchuk DM, Lennon VA, Lucchinetti CF, Pittock SJ, Weinshenker BG. The spectrum of neuromyelitis optica. Lancet Neurol. 2007 Sep;6(9):805-815.

5. Borisow N, Hellwig K, Paul F. Neuromyelitis optica spectrum disorders and pregnancy: relapse-preventive measures and personalized treatment strategies. EPMA J. 2018 Aug;9(3):249- 256.

6. Frohman EM, Frohman TC, Zee DS, McColl R, Galetta S. The neuro- ophthalmology of multiple sclerosis. Lancet Neurol. 2005 Feb;4(2):111121.

7. Bennett JL, de Seze J, Lana-Peixoto M, et al. Neuromyelitis optica and multiple sclerosis: Seeing differences through optical coherence tomography. Mult Scler. 2015 May;21(6):678-688.

8. Kim W, Kim SH, Nakashima I, et al. Influence of pregnancy on neuromyelitis optica spectrum disorder. Neurology. 2012 Apr;78(16):1264-1267.

9. Klawiter EC, Bove R, Elsone L, et al. High risk of postpartum relapses in neuromyelitis optica spectrum disorder. Neurology. 2017 Nov;89(22):2238-2244.

10. Mao-Draayer Y, Thiel S, Mills EA, et al. Neuromyelitis optica spectrum disorders and pregnancy: therapeutic considerations. Nat Rev Neurol. 2020 Mar;16(3):154-170.

11. Nour MM, Nakashima I, Coutinho E, et al. Pregnancy outcomes in aquaporin-4-positive neuromyelitis optica spectrum disorder. Neurology. 2016 Jan;86(1):79-87.

12. Wang L, Zhou L, ZhangBao J et al. Neuromyelitis optica spectrum disorder: pregnancy-related attack and predictive risk factors. J Neurol Neurosurg Psychiatry. 2020 Nov;92(1):53–61.

13. Salvador NRS, Brito MNG, Alvarenga MP, Alvarenga RMP. Neuromyelitis optica and pregnancy-puerperal cycle. Mult Scler Relat Disord. 2019 Sep;34:59-62.

14. Davoudi V, Keyhanian K, Bove RM, Chitnis T. Immunology of neuromyelitis optica during pregnancy. Neurol Neuroimmunol Neuroinflamm. 2016 Oct;3(6):e288.

15. D’Souza R, Wuebbolt D, Andrejevic K, et al. Pregnancy and Neuromyelitis Optica Spectrum Disorder - Reciprocal Effects and Practical Recommendations: A Systematic Review. Front Neurol. 2020 Oct;11:544434.

16. Macaron G, Khoury J, Bena J, et al. Early age of onset predicts severity of visual impairment in patients with neuromyelitis optica spectrum disorder. Mult Scler. 2021 Jan;e1352458520981736.

17. Bock M, Brandt AU, Dörr J, et al. Time domain and spectral domain optical coherence tomography in multiple sclerosis: A comparative cross-sectional study. Mult Scler. 2010 Jul;16(7):893-896.

18. Zhao X, Qiu W, Zhang Y, et al. A prospective case-control study comparing optical coherence tomography characteristics in neuromyelitis optica spectrum disorder- optic neuritis and idiopathic optic neuritis. BMC Ophthalmol. 2018 Sep;18(1):247.

19. De Seze J, Blanc F, Jeanjean L, et al. Optical coherence tomography in neuromyelitis optica. Arch Neurol. 2008 Jul;65(7):920-923.

20. Nakamura M, Nakazawa T, Doi H, et al. Early high-dose intravenous methylprednisolone is effective in preserving retinal nerve fiber layer thickness in patients with neuromyelitis optica. Graefes Arch Clin Exp Ophthalmol. 2010 Dec;248(12):1777- 1785.