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- Title
Radiological differentiation of optic neuritis with myelin oligodendrocyte glycoprotein antibodies, aquaporin-4 antibodies, and multiple sclerosis.
- Authors
Ramanathan, Sudarshini; Prelog, Kristina; Barnes, Elizabeth H.; Tantsis, Esther M.; Reddel, Stephen W.; Henderson, Andrew P. D.; Vucic, Steve; Gorman, Mark P.; Benson, Leslie A.; Alper, Gulay; Riney, Catherine J.; Barnett, Michael; Parratt, John D. E.; Hardy, Todd A.; Leventer, Richard J.; Merheb, Vera; Nosadini, Margherita; Fung, Victor S. C.; Brilot, Fabienne; Dale, Russell C.
- Abstract
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.
- Subjects
OPTIC neuritis; MYELIN oligodendrocyte glycoprotein; MULTIPLE sclerosis; AQUAPORINS; VISION disorders
- Publication
Multiple Sclerosis Journal, 2016, Vol 22, Issue 4, p470
- ISSN
1352-4585
- Publication type
Article
- DOI
10.1177/1352458515593406