Comparison of clinico-radiological profile, optical coherence tomography parameters, and outcome in MOGAD and Neuromyelitis optica spectrum disorder subtypes: A prospective observational study

Dhar, Nikita; Kumar, Mritunjai; Tiwari, Ashutosh; Samanta, Ramanuj; Bhadoria, Ajeet Singh; Subbiah, Vivekanandhan; Saxena, Sudhir; Kumar, Niraj

doi:10.25259/jnrp_8_2022

Cited by 2 publications

(4 citation statements)

References 36 publications

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“…Several prior studies have shown a lower N:T ratio in NMO compared with MS (i.e., 0.93 ± 0.35 vs 1.36 ± 0.43), largely due to predominant temporal thinning in MS vs. diffuse thinning in NMO. 17,18 It appears that N:T ratio could be higher on average in both MS-ON and MOG-ON compared with NMO-ON. Further higher-powered studies would need to be done to confirm this.…”

Section: Discussionmentioning

confidence: 98%

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Myelin Oligodendrocyte Glycoprotein Antibody Disease Optic Neuritis: A Structure–Function Paradox?

Ross,

Kenney,

Balcer

et al. 2024

Journal of Neuro-Ophthalmology

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Background: Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) is a demyelinating disorder that most commonly presents with optic neuritis (ON) and affects children more often than adults. We report 8 pediatric patients with MOG-associated ON and characterize focal optical coherence tomography (OCT) abnormalities over time that help distinguish this condition from the trajectories of other demyelinating disorders. These OCT findings are examined in the context of longitudinal visual function testing. Methods: This is a retrospective case series of 8 pediatric patients with MOG-associated ON who were referred for neuro-ophthalmic evaluation. Longitudinal data for demographics, clinical history, physical examination, and OCT obtained in the course of clinical evaluations were collected through retrospective medical record review. Results: Patients demonstrated acute peripapillary retinal nerve fiber layer (RNFL) thickening in one or both eyes, consistent with optic disc swelling. This was followed by steady patterns of average RNFL thinning, with 9 of 16 eyes reaching significantly low RNFL thickness using OCT platform reference databases (P < 0.01), accompanied by paradoxical recovery of high-contrast visual acuity (HCVA) in every patient. There was no correlation between HCVA and any OCT measures, although contrast sensitivity (CS) was associated with global thickness, PMB thickness, and nasal/temporal (N/T) ratio, and color vision was associated with PMB thickness. There was a lower global and papillomacular bundle (PMB) thickness (P < 0.01) in clinically affected eyes compared with unaffected eyes. There was also a significantly higher N:T ratio in clinically affected eyes compared with unaffected eyes in the acute MOG-ON setting (P = 0.03), but not in the long-term setting. Conclusions: MOG shows a pattern of prominent retinal atrophy, as demonstrated by global RNFL thinning, with remarkable preservation of HCVA but remaining deficits in CS and color vision. These tests may be better clinical markers of vision changes secondary to MOG-ON. Of the OCT parameters measured, PMB thickness demonstrated the most consistent correlation between structural and functional measures. Thus, it may be a more sensitive marker of clinically significant retinal atrophy in MOG-ON. The N:T ratio in acute clinically affected MOG-ON eyes in our study was higher than the N:T ratio of neuromyelitis optica (NMO)-ON eyes and similar to the N:T ratio in multiple sclerosis (MS)-ON eyes as presented in the prior literature. Therefore, MOG may share a more similar pathophysiology to MS compared with NMO.

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Section: Discussionmentioning

confidence: 98%

“…As seen in Table 1, 8 cases were included in the analysis (3 female, 5 male). Median age at disease onset was 13 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) years. All patients had a MOG titer of 1:100-1:1,000 and had ON as determined by inclusion criteria.…”

Section: Patient Characteristicsmentioning

confidence: 99%

Myelin Oligodendrocyte Glycoprotein Antibody Disease Optic Neuritis: A Structure–Function Paradox?

Ross,

Kenney,

Balcer

et al. 2024

Journal of Neuro-Ophthalmology

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“…Тем не менее степень частичной атрофии ЗН, развивающейся в отдаленном периоде ОН, также может различаться в зависимости от конкретного демиелинизирующего заболевания. Оценивать толщину перипапиллярного СНВС и комплекса ГКС следует не ранее чем через 6 мес после перенесенного ОН, когда произошли все структурные изменения на уровне данных структур ЗН [12].…”

Section: Conclusion the Study Showed The Most Pronounced Structural A...unclassified

“…В связи с этим различается прогноз восстановления ОЗ пациентов с МОГАЗ с единственным эпизодом ОН и с ремиттирующим течением ОН. Конечная ОЗ у обследуемых нами пациентов подгруппы МОG-ОНр была значимо ниже по сравнению с показателями пациентов с единственным эпизодом МОG-ОН и не отличалась от таковой в группе AQP4-OН, что свидетельствует о необходимости своевременной профилактики обострений для снижения инвалидизации пациентов [12].…”

Section: Va In Demyelinating Onunclassified

Optic neuritis in various demyelinating diseases

Kalashnikova,

Eliseeva,

Andreeva

et al. 2024

RJTAO

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The discovery of antibodies against aquaporin-4 (AQP4) and against myelinoligodendrocyte glycoprotein (MOG) confirmed the existence of two disease entities distinct from multiple sclerosis (MS) — neuromyelitis optica spectrum disorders (NMOSD) and myelinoligodendrocyte glycoprotein-associated disease (MOGAD). Demyelinating optic neuritis (ON) can be either idiopathic (iDON) or a manifestation of MS, NMOSD (AQP4-ON) or MOGAD (MOG-ON).Objective: to determine the clinical features of ON and to evaluate the diagnostic value of optical coherence tomography (OCT) in demyelinating diseases of the central nervous system.Material and methods. The study included 43 patients with demyelinating ON who were divided into three groups according to the underlying disease (NMOSD, MOGAD and MS/iDON). We assessed visual acuity (VA) in the acute phase and analyzed VA and average values of retinal nerve fiber layer thickness (RNFL) and retinal ganglion cell complex (RGC) thickness using OCT data 6 months after the onset of ON.Results. ON was observed in the onset of the disease in 75% of NMOSD patients, 62% of MOGAD patients and 86% of MS/iDON patients. In the MOGAD and NMOSD groups, bilateral ON was predominantly observed. In 65% of patients with MOGAD (MOG-ONr), a recurrent course of ON was observed. VA was significantly lower in patients with AQP4-ON in acute phase and comparable to the MOG-ONr group in the long-term phase. VA in the onset of MOG-ON with a single episode was comparable to that of MS/iDON (p=0.2), but recovery was less pronounced (p=0.03). The most significant thinning of the RNFL and RGC complex was observed in the AQP4-ON and MOG-ONr groups. In AQP4-ON and MOG-ON groups, restoration of VA up to 0.5 and higher was observed significantly more frequently in the group of patients receiving pulse therapy with glucocorticoids (p=0.018).Conclusion. The study showed the most pronounced structural and functional disturbances in the long-term phase of AQP4-ON and MOG-ONr. MOG-ON was characterized by a high frequency of relapses with the influence of this factor on VA and thinning of the retinal layers in the long-term.

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Comparison of clinico-radiological profile, optical coherence tomography parameters, and outcome in MOGAD and Neuromyelitis optica spectrum disorder subtypes: A prospective observational study

Cited by 2 publications

References 36 publications

Myelin Oligodendrocyte Glycoprotein Antibody Disease Optic Neuritis: A Structure–Function Paradox?

Myelin Oligodendrocyte Glycoprotein Antibody Disease Optic Neuritis: A Structure–Function Paradox?

Optic neuritis in various demyelinating diseases

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