タカハシ ヨウヘイ   TAKAHASHI Youhei
  髙橋 洋平
   所属   医学部 医学科(東京女子医科大学病院)
   職種   助教
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Intravenous immunoglobulin for the acute treatment of refractory optic neuritis in Japan.
掲載誌名 正式名:Japanese journal of ophthalmology
略  称:Jpn J Ophthalmol
ISSNコード:16132246/00215155
掲載区分国外
巻・号・頁 69,pp.1-14
著者・共著者 Yohei Takahashi, Takeshi Kezuka, Keigo Shikishima, Akiko Yamagami, Hideki Chuman, Makoto Nakamura, Satoshi Ueki, Akiko Kimura, Masato Hashimoto, Sonoko Tatsui, Nobuyuki Shoji, Hitoshi Ishikawa,
担当区分 筆頭著者,責任著者
発行年月 2025/05/16
概要 PURPOSE:To investigate the usage status and evaluate the efficacy of intravenous immunoglobulin (IVIG) for the acute treatment of optic neuritis (ON) in Japan.STUDY DESIGN:Multicenter retrospective case series.METHODS:The study subjects were patients with steroid-resistant acute ON in whom IVIG had been initiated between January 2020 and August 2022 at 30 facilities in Japan. The clinical characteristics, visual acuity, and adverse events following IVIG were compared among anti-aquaporin 4 antibody positive ON (AQP4-ON), anti-myelin oligodendrocyte glycoprotein antibody positive ON (MOG-ON), and idiopathic ON (ION).RESULTS:The study included sixty-five patients (76 eyes); the main clinical department administering IVIG was ophthalmology (50 cases, 77.0 %). 43 cases had their first ON attack and 22 cases had recurrent ON. Plasmapheresis (PP) was combined in 21 cases. The efficacy endpoint, changes in logarithm of the minimum angle of resolution (logMAR) after IVIG compared with preIVIG, showed statistically significant improvement in the AQP4-ON group at one week, 4 weeks, and 12 weeks after IVIG (p=0.015, p<0.001, p<0.001, respectively). In the MOG-ON group, excluding cases with combined PP, logMAR post IVIG did not improve significantly compared with preIVIG. Among the ION group, compared with preIVIG, logMAR at 4weeks and 12 weeks post IVIG were statistically significant improved (p=0.019, p=0.023, respectively). Adverse events occurred in 7 patients with IVIG. 4 of the 7 patients continued the IVIG treatment, and 3 patients discontinued it within 5 days.CONCLUSION:This study demonstrates that IVIG may be an effective new option for acute treatment of steroid-resistant ON as an add-on to conventional therapy.
DOI 10.1007/s10384-025-01210-6
PMID 40377800