Differences in morphology and visual function of myelin oligodendrocyte glycoprotein antibody and multiple sclerosis associated optic neuritis

Rino Vicini,Dominik Brügger,Hilary Michelle Grabe,Mathias Abegg,Anke Salmen

doi:10.1007/s00415-020-10097-x

Abstract

BackgroundMyelin oligodendrocyte glycoprotein immunoglobulin G associated optic neuritis (MOG-ON) is a recently described entity. Recent studies have shown that MOG-ON has a more severe clinical presentation than classic optic neuritis (ON).ObjectiveThis study aimed to define morphological characteristics of MOG-ON, correlate these with clinical characteristics and compare them with multiple sclerosis associated ON (MS-ON) and healthy controls (CTRL).MethodsIn a retrospective study, we included MOG-ON and MS-ON patients seen between 2011 and 2018 at the University Hospital Bern. Data from clinical examination, perimetry, and optical coherence tomography (OCT) were analyzed.ResultsA total of 66 eyes of 43 patients were included; 22 MS-ON and 33 CTRL eyes were sex- and age-matched to 11 MOG-ON eyes. We found significantly worse visual acuity at nadir, but better recovery and thinner global peripapillary retinal nerve fiber layer thickness in MOG-ON patients compared to MS-ON patients. Both groups exhibited irregular thinning of the macular ganglion cell layer. Furthermore, the visual acuity and visual field parameters correlated to retinal layer thickness only in MOG-ON eyes.ConclusionIn comparison to MS-ON, MOG-ON is associated with more prominent acute vision loss and more pronounced global thinning of the pRNFL. Both entities result in similar final visual acuity and atrophy of the macular ganglion cell layer.

Highlights

The detection of myelin oligodendrocyte glycoprotein (MOG) antibodies in cases of optic neuritis (ON) has recently led to the differentiation of MOG immunoglobulin G associated optic neuritis (MOG-ON) from the more common idiopathic or multiple sclerosis (MS) associated optic neuritis (MS-ON) [1, 2]
It has recently been shown that adding the macular ganglion cell layer thickness may have a better sensitivity than peripapillary nerve fiber layer (pRNFL) alone in detecting optic neuropathies, and that the distribution of mGCL loss may provide additional localizing value of optic neuropathies [5, 6]
We found 11 eyes of six MOG antibody seropositive patients with confirmed optic neuritis and optical coherence tomography (OCT) images of good

Summary

Introduction

The detection of myelin oligodendrocyte glycoprotein (MOG) antibodies in cases of optic neuritis (ON) has recently led to the differentiation of MOG immunoglobulin G associated optic neuritis (MOG-ON) from the more common idiopathic or multiple sclerosis (MS) associated optic neuritis (MS-ON) [1, 2]. We found significantly worse visual acuity at nadir, but better recovery and thinner global peripapillary retinal nerve fiber layer thickness in MOG-ON patients compared to MS-ON patients. Both groups exhibited irregular thinning of the macular ganglion cell layer. Conclusion In comparison to MS-ON, MOG-ON is associated with more prominent acute vision loss and more pronounced global thinning of the pRNFL. Both entities result in similar final visual acuity and atrophy of the macular ganglion cell layer

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