Myelin Oligodendrocyte Glycoprotein Antibody–Positive Optic Neuritis: Clinical Characteristics, Radiologic Clues, and Outcome

Chen, John J.; Flanagan, Eoin P.; Jitprapaikulsan, Jiraporn; López-Chiriboga, A. Sebastian; Fryer, James P.; Leavitt, Jacqueline A.; Weinshenker, Brian G.; McKeon, Andrew; Tillema, Jan‐Mendelt; Lennon, Vanda A.; Tobin, W. Oliver; Keegan, B. Mark; Lucchinetti, Claudia F.; Kantarci, Orhun H.; McClelland, Collin M.; Lee, Michael S.; Bennett, Jeffrey L.; Pelak, Victoria S.; Chen, Yanjun; VanStavern, Gregory; Adesina, Ore‐Ofeoluwatomi O; Eggenberger, Eric; Acierno, Marie D; Wingerchuk, Dean M.; Brazis, Paul W.; Sagen, Jessica; Pittock, Sean J.

doi:10.1016/j.ajo.2018.07.020

Cited by 316 publications

(342 citation statements)

References 29 publications

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“…19). 114 Peri-optic nerve enhancement (nerve sheath enhancement) is also often apparent. 114 Peri-optic nerve enhancement (nerve sheath enhancement) is also often apparent.…”

Section: Brain Lesionsmentioning

confidence: 99%

“…112 The optic chiasm is involved in 12% of patients, and the optic tract is involved in 2% of patients. 102,112,114 Enhancement of the surrounding orbital fat might be identified. 102,112,114 Enhancement of the surrounding orbital fat might be identified.…”

Section: Brain Lesionsmentioning

confidence: 99%

“…102,112,114 Enhancement of the surrounding orbital fat might be identified. 114 Spinal cord lesions Most spinal cord lesions present LETM (Fig. 114 Spinal cord lesions Most spinal cord lesions present LETM (Fig.…”

Section: Brain Lesionsmentioning

confidence: 99%

“…114 Peri-optic nerve enhancement (nerve sheath enhancement) is also often apparent. 102,112,114 Enhancement of the surrounding orbital fat might be identified. 102 Approximately 80% of patients experience ≥2 attacks of optic neuritis, although the majority of patients show significant recovery.…”

Section: Brain Lesionsmentioning

confidence: 99%

“…102 Approximately 80% of patients experience ≥2 attacks of optic neuritis, although the majority of patients show significant recovery. 114…”

Section: Brain Lesionsmentioning

confidence: 99%

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Magnetic resonance imaging diagnosis of demyelinating diseases: An update

Miki

2019

Clinical & Exp Neuroim

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Keywords acute disseminating encephalomyelitis (ADEM); demyelinating diseases; multiple sclerosis (MS); myelin oligodendrocyte glycoprotein (MOG) encephalomyelitis; neuromyelitis optica spectrum disorder (NMOSD) Correspondence AbstractMajor demyelinating diseases include multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), acute disseminated encephalomyelitis (ADEM) and myelin oligodendrocyte glycoprotein (MOG) encephalomyelitis. As treatment strategies differ among these diseases, precise diagnosis of demyelinating diseases is crucial, and magnetic resonance imaging (MRI) plays a pivotal role in the diagnosis. In the present review, MRI appearances of characteristic lesions of these demyelinating diseases, and differentiation between MS and other demyelinating diseases based on MRI findings are discussed.

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“…19). 114 Peri-optic nerve enhancement (nerve sheath enhancement) is also often apparent. 114 Peri-optic nerve enhancement (nerve sheath enhancement) is also often apparent.…”

Section: Brain Lesionsmentioning

confidence: 99%

Section: Brain Lesionsmentioning

confidence: 99%

Section: Brain Lesionsmentioning

confidence: 99%

Section: Brain Lesionsmentioning

confidence: 99%

“…102 Approximately 80% of patients experience ≥2 attacks of optic neuritis, although the majority of patients show significant recovery. 114…”

Section: Brain Lesionsmentioning

confidence: 99%

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Magnetic resonance imaging diagnosis of demyelinating diseases: An update

Miki

2019

Clinical & Exp Neuroim

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Application of 2015 Seronegative Neuromyelitis Optica Spectrum Disorder Diagnostic Criteria for Patients With Myelin Oligodendrocyte Glycoprotein IgG–Associated Disorders

et al. 2020

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Association of Maintenance Intravenous Immunoglobulin With Prevention of Relapse in Adult Myelin Oligodendrocyte Glycoprotein Antibody–Associated Disease

et al. 2022

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IMPORTANCE Recent studies suggest that maintenance intravenous immunoglobulin (IVIG) may be an effective treatment to prevent relapses in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD); however, most of these studies had pediatric cohorts, and few studies have evaluated IVIG in adult patients.OBJECTIVE To determine the association of maintenance IVIG with the prevention of disease relapse in a large adult cohort of patients with MOGAD. DESIGN, SETTING, AND PARTICIPANTSThis was a retrospective cohort study conducted from January 1, 2010, to October 31, 2021. Patients were recruited from 14 hospitals in 9 countries and were included in the analysis if they (1) had a history of 1 or more central nervous system demyelinating attacks consistent with MOGAD, (2) had MOG-IgG seropositivity tested by cell-based assay, and (3) were age 18 years or older when starting IVIG treatment. These patients were retrospectively evaluated for a history of maintenance IVIG treatment. EXPOSURES Maintenance IVIG.MAIN OUTCOMES AND MEASURES Relapse rates while receiving maintenance IVIG compared with before initiation of therapy. RESULTSOf the 876 adult patients initially identified with MOGAD, 59 (median [range] age, 36 [18-69] years; 33 women [56%]) were treated with maintenance IVIG. IVIG was initiated as first-line immunotherapy in 15 patients (25%) and as second-line therapy in 37 patients (63%) owing to failure of prior immunotherapy and in 7 patients (12%) owing to intolerance to prior immunotherapy. The median (range) annualized relapse rate before IVIG treatment was 1.4 (0-6.1), compared with a median (range) annualized relapse rate while receiving IVIG of 0 (0-3) (t 108 = 7.14; P < .001). Twenty patients (34%) had at least 1 relapse while receiving IVIG with a median (range) time to first relapse of 1 (0.03-4.8) years, and 17 patients (29%) were treated with concomitant maintenance immunotherapy. Only 5 of 29 patients (17%) who received 1 g/kg of IVIG every 4 weeks or more experienced disease relapse compared with 15 of 30 patients (50%) treated with lower or less frequent dosing (hazard ratio, 3.31; 95% CI, 1.19-9.09; P = .02). At final follow-up, 52 patients (88%) were still receiving maintenance IVIG with a median (range) duration of 1.7 (0.5-9.9) years of therapy. Seven of 59 patients (12%) discontinued IVIG therapy: 4 (57%) for inefficacy, 2 (29%) for adverse effects, and 1 (14%) for a trial not receiving therapy after a period of disease inactivity.CONCLUSIONS AND RELEVANCE Results of this retrospective, multicenter, cohort study of adult patients with MOGAD suggest that maintenance IVIG was associated with a reduction in disease relapse. Less frequent and lower dosing of IVIG may be associated with treatment failure. Future prospective randomized clinical trials are warranted to confirm these findings.

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Myelin Oligodendrocyte Glycoprotein Antibody–Positive Optic Neuritis: Clinical Characteristics, Radiologic Clues, and Outcome

Abstract: Manifestations of MOG-IgG-positive optic neuritis are diverse. Despite recurrent attacks with severe vision loss, the majority of patients have significant recovery and retain functional vision long-term.

Cited by 316 publications

References 29 publications

Magnetic resonance imaging diagnosis of demyelinating diseases: An update

Magnetic resonance imaging diagnosis of demyelinating diseases: An update

Application of 2015 Seronegative Neuromyelitis Optica Spectrum Disorder Diagnostic Criteria for Patients With Myelin Oligodendrocyte Glycoprotein IgG–Associated Disorders

Association of Maintenance Intravenous Immunoglobulin With Prevention of Relapse in Adult Myelin Oligodendrocyte Glycoprotein Antibody–Associated Disease

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