ABSTRACT
Objective To investigate the clinical and imaging features of the aquaporin-4 (AQP4)antibody-negative binocular optic neuritis and to analyze the predictive factors of visual function outcome.Methods Fifty-eight patients with AQP4-negative binocular optic neuritis were reviewed and followed up from January 2014 to December 2015.Patients at baseline and at the end of follow-up were evaluated for visual function and neurological examination.All patients underwent optic nerve and brain MRI, cerebrospinal fluid and routine laboratory tests.Results AQP4 antibody-negative binocular optic neuritis accounted for 9.4%(58/615)of the total optic neuritis in the same period.At baseline, 99 eyes (85.3%,99/116)had best corrected visual acuity<0.1.At the end of follow-up, 31 eyes(26.7%,31/116) had best corrected visual acuity < 0.1. There were 43 cases (74.1%, 43/58) with multi-segment involvement of optic nerve at the baseline.Baseline visual acuity(P=0.005), early treatment response (P=0.011), and segment numbers of optic nerve involvement(P=0.025)were independently associated with end-point outcome of visual function.Forty-nine patients(84.5%,49/58)showed monophasic course in (3.1 ± 0.9) years follow-up period, 7 cases (12.1%, 7/58) had recurrence, and 2 cases (3.4%, 2/58) converted to neuromyelitis optic spectrum disorder (NMOSD). Conclusions AQP4 antibody-negative binocular optic neuritis is common and the recovery of visual function is not satisfied. Baseline visual function and the length of optic lesion in MRI is related to the end-point prognosis. Most patients performs the single phase course during the follow-up period.