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Mult Scler. 2019 Jul 31:1352458519864928. doi: 10.1177/1352458519864928. [Epub ahead of print]

Aquaporin-4 IgG seropositivity is associated with worse visual outcomes after optic neuritis than MOG-IgG seropositivity and multiple sclerosis, independent of macular ganglion cell layer thinning.

Author information

1
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
2
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA/Department of Neurology, University of Alexandria, Alexandria, Egypt.
3
Department of Biostatistics, Johns Hopkins University, Baltimore, MD, USA.
4
Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA.

Abstract

BACKGROUND:

Comparative studies of characteristics of optic neuritis (ON) associated with myelin oligodendrocyte glycoprotein-IgG (MOG-ON) and aquaporin-4-IgG (AQP4-ON) seropositivity are limited.

OBJECTIVE:

To compare visual and optical coherence tomography (OCT) measures following AQP4-ON, MOG-ON, and multiple sclerosis associated ON (MS-ON).

METHODS:

In this cross-sectional study, 48 AQP4-ON, 16 MOG-ON, 40 MS-ON, and 31 healthy control participants underwent monocular letter-acuity assessment and spectral-domain OCT. Eyes with a history of ON >3 months prior to evaluation were analyzed.

RESULTS:

AQP4-ON eyes exhibited worse high-contrast letter acuity (HCLA) compared to MOG-ON (-22.3 ± 3.9 letters; p < 0.001) and MS-ON eyes (-21.7 ± 4.0 letters; p < 0.001). Macular ganglion cell + inner plexiform layer (GCIPL) thickness was lower, as compared to MS-ON, in AQP4-ON (-9.1 ± 2.0 µm; p < 0.001) and MOG-ON (-7.6 ± 2.2 µm; p = 0.001) eyes. Lower GCIPL thickness was associated with worse HCLA in AQP4-ON (-16.5 ± 1.5 letters per 10 µm decrease; p < 0.001) and MS-ON eyes (-8.5 ± 2.3 letters per 10 µm decrease; p < 0.001), but not in MOG-ON eyes (-5.2 ± 3.8 letters per 10 µm decrease; p = 0.17), and these relationships differed between the AQP4-ON and other ON groups (p < 0.01 for interaction).

CONCLUSION:

AQP4-IgG seropositivity is associated with worse visual outcomes after ON compared with MOG-ON and MS-ON, even with similar severity of macular GCIPL thinning.

KEYWORDS:

Optic neuritis; multiple sclerosis; myelin oligodendrocyte glycoprotein; neuromyelitis optica; optical coherence tomography

PMID:
31364464
DOI:
10.1177/1352458519864928

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