ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2025
Effects of coronavirus disease 2019 in patients with optic neuritis: a single-centre retrospective cohort study.
Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe 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.
methodsWe 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.
resultsA 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.
conclusionsCOVID-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.
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