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Background <p>The relationship between coronavirus disease 2019 (COVID-19) and optic neuritis (ON) remains unclear, with limited evidence on its clinical features and outcomes. This study aimed to investigate the impact of COVID-19 on ON subtypes and prognosis.</p> Methods <p>We conducted a single-centre retrospective cohort study, comparing acute ON patients with and without recent COVID-19 infection during the omicron wave (December 2022 to January 2023). A historical control group from the pre-COVID-19 era was included for comparison.</p> Results <p>A total of 55 ON patients were included, of whom 12 had recent COVID-19 infection. COVID-19-associated ON showed a higher incidence of acute disseminated encephalomyelitis-associated ON (ADEM-ON, 25% vs. 0%) and a lower rate of aquaporin-4 antibody-associated ON (AQP4-ON, 0% vs. 31.4%). These patients presented more frequently with eye pain (75%) and respiratory symptoms (60%). At onset, 66.7% experienced severe visual loss (mean logMAR 1.10 ± 0.71), but most (83.3%) achieved good visual recovery (mean logMAR 0.08 ± 0.44) after immunotherapy. Only one relapse was observed during follow-up.</p> Conclusions <p>COVID-19 may trigger distinct autoimmune processes in ON, particularly increasing ADEM-ON prevalence. Despite initial severe vision loss, outcomes are generally favourable with timely treatment. These findings expand understanding of neuro-ophthalmic complications related to COVID-19.</p>

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Effects of coronavirus disease 2019 in patients with optic neuritis: a single-centre retrospective cohort study

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  • 发表日期：

    2025年7月29日

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  • Rong Yan,
  • Yanjun Guo,
  • Chao Meng,
  • Xiuyun Kong,
  • Jiawei Wang

摘要

Background

The relationship between coronavirus disease 2019 (COVID-19) and optic neuritis (ON) remains unclear, with limited evidence on its clinical features and outcomes. This study aimed to investigate the impact of COVID-19 on ON subtypes and prognosis.

Methods

We conducted a single-centre retrospective cohort study, comparing acute ON patients with and without recent COVID-19 infection during the omicron wave (December 2022 to January 2023). A historical control group from the pre-COVID-19 era was included for comparison.

Results

A total of 55 ON patients were included, of whom 12 had recent COVID-19 infection. COVID-19-associated ON showed a higher incidence of acute disseminated encephalomyelitis-associated ON (ADEM-ON, 25% vs. 0%) and a lower rate of aquaporin-4 antibody-associated ON (AQP4-ON, 0% vs. 31.4%). These patients presented more frequently with eye pain (75%) and respiratory symptoms (60%). At onset, 66.7% experienced severe visual loss (mean logMAR 1.10 ± 0.71), but most (83.3%) achieved good visual recovery (mean logMAR 0.08 ± 0.44) after immunotherapy. Only one relapse was observed during follow-up.

Conclusions

COVID-19 may trigger distinct autoimmune processes in ON, particularly increasing ADEM-ON prevalence. Despite initial severe vision loss, outcomes are generally favourable with timely treatment. These findings expand understanding of neuro-ophthalmic complications related to COVID-19.