Radiological differentiation of optic neuritis with myelin oligodendrocyte glycoprotein antibodies, aquaporin-4 antibodies, and multiple sclerosis
S Ramanathan, K Prelog, EH Barnes… - Multiple Sclerosis …, 2016 - journals.sagepub.com
S Ramanathan, K Prelog, EH Barnes, EM Tantsis, SW Reddel, APD Henderson, S Vucic…
Multiple Sclerosis Journal, 2016•journals.sagepub.comBackground: Recognizing the cause of optic neuritis (ON) affects treatment decisions and
visual outcomes. Objective: We aimed to define radiological features of first-episode
demyelinating ON. Methods: We performed blinded radiological assessment of 50 patients
presenting with first-episode myelin oligodendrocyte glycoprotein (MOG) antibody-
associated ON (MOG-ON; n= 19), aquaporin-4 (AQP4) antibody-associated ON (AQP4-ON;
n= 11), multiple sclerosis (MS)-associated ON (MS-ON; n= 13), and unclassified ON (n= 7) …
visual outcomes. Objective: We aimed to define radiological features of first-episode
demyelinating ON. Methods: We performed blinded radiological assessment of 50 patients
presenting with first-episode myelin oligodendrocyte glycoprotein (MOG) antibody-
associated ON (MOG-ON; n= 19), aquaporin-4 (AQP4) antibody-associated ON (AQP4-ON;
n= 11), multiple sclerosis (MS)-associated ON (MS-ON; n= 13), and unclassified ON (n= 7) …
Background
Recognizing the cause of optic neuritis (ON) affects treatment decisions and visual outcomes.
Objective
We aimed to define radiological features of first-episode demyelinating ON.
Methods
We performed blinded radiological assessment of 50 patients presenting with first-episode myelin oligodendrocyte glycoprotein (MOG) antibody-associated ON (MOG-ON; n=19), aquaporin-4 (AQP4) antibody-associated ON (AQP4-ON; n=11), multiple sclerosis (MS)-associated ON (MS-ON; n=13), and unclassified ON (n=7).
Results
Bilateral involvement was more common in MOG-ON and AQP4-ON than MS-ON (84% vs. 82% vs. 23%), optic nerve head swelling was more common in MOG-ON (53% vs. 9% vs. 0%), chiasmal involvement was more common in AQP4-ON (5% vs. 64% vs. 15%), and bilateral optic tract involvement was more common in AQP4-ON (0% vs. 45% vs. 0%). Retrobulbar involvement was more common in MOG-ON, whereas intracranial involvement was more common in AQP4-ON. MOG-ON and AQP4-ON had longer lesion lengths than MS-ON. The combination of two predictors, the absence of magnetic resonance imaging brain abnormalities and a higher lesion extent score, showed a good ability to discriminate between an autoantibody-associated ON (MOG or AQP4) and MS. AQP4-ON more frequently had severe and sustained visual impairment.
Conclusion
MOG-ON and AQP4-ON are more commonly bilateral and longitudinally extensive. MOG-ON tends to involve the anterior optic pathway, whereas AQP4-ON the posterior optic pathway.
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