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Plasmapheresis for optic neuritis refractory to corticosteroid pulse therapy Ryusaku Matsuda 1 , Takeshi Kezuka 1 , Yoshimichi Matsunaga 1 , Hiroya Utsumi 2 , Masayuki Masuda 2 , Hiroo Terashi 2 , Keiko Tanaka 3 , Hiroshi Goto 1 1Dept of Ophthalmol,Tokyo Med Univ 2Dept of Neurol,Tokyo Med Univ 3Dept of Neurol,Kanazawa Med Univ pp.545-551
Published Date 2012/4/15
DOI https://doi.org/10.11477/mf.1410104174
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Abstract. Purpose:To report the outcome of plasmapheresis for optic neuritis. Cases and Method:This retrospective study was made on consecutive 12 eyes of 8 patients who received double filtration plasmapheresis for exacerbation of optic neuritis. All the cases had failed to respond to pulsed corticosteroid therapy. All the cases were females. They were aged from 30 to 72 years,average 48 years. Optic neuromyelitis was present in 9 eyes of 6 cases and idiopathic optic neuritis in 3 eyes of 2 cases. All the cases were examined for anti-aquaporin-4(anti-AQP-4)antibody. Effect of treatment was evaluated with visual acuity and Goldmann visual field as parameters. Results:Anti-AQP-4 antibody was positive in 5 cases and negative in 3 cases. Plasmaphoresis was followed by increased visual acuity by 2 lines or more in 9 eyes of 7 cases. All the cases with negative anti-AQP-4 antibody showed improvement. There was no improvement in 3 eyes of 2 cases who had had repeated recurrences and who were among 5 cases positive for anti-AQP-4 antibody. Conclusion:Double filtration plasmapheresis was effective for optic neuritis in cases with negative anti-AQP-4 antibody. The treatment was of limited value in cases with positive anti-AQP-4 antibody and with past history of repeated recurrences.


Copyright © 2012, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1308 印刷版ISSN 0370-5579 医学書院

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