TY - JOUR
T1 - Unique characteristics of optical coherence tomography (OCT) results and visual acuity testing in myelin oligodendrocyte glycoprotein (MOG) antibody positive pediatric patients
AU - Narayan, Ram N.
AU - McCreary, Morgan
AU - Conger, Darrel
AU - Wang, Cynthia
AU - Greenberg, Benjamin M.
N1 - Funding Information:
Dr. Greenberg has received grant funding from Chugai, Medimmune, Genentech, Medday, PCORI, NIH, NMSS, TMA and GJCF. He has received consulting fees from Alexion, Novartis and EMD Serono. He sits on the advisory board of the TMA.
Funding Information:
Dr. Narayan's fellowship is supported by the National Multiple Sclerosis Society's Institutional Award. There are no conflicts relevant to this study.
Funding Information:
Dr. Cynthia Wang's fellowship is supported by the Transverse Myelitis Association. She has received compensation from Medical Logix, a continuing medical education company, for grant writing on Multiple Sclerosis topics. There are no conflicts relevant to this study.
Publisher Copyright:
© 2018
PY - 2019/2
Y1 - 2019/2
N2 - Background: Optic nerve involvement in anti-myelin oligodendrocyte glycoprotein antibody associated syndrome (MOG ab syndrome) tends to have unique features. Few studies have reported optical coherence tomography (OCT) measures like retinal nerve fiber layer thickness findings in the setting of pediatric MOG ab syndrome. Objectives: The aim of this study is to compare visual acuity between MOG ab positive and MOG ab negative pediatric cohorts and examine correlations with OCT findings. Methods: We included outpatients less than 18 years of age who had optic neuritis (ON) of at least one eye and who completed visual testing and OCT in the study. ON was defined based on clinical or OCT findings. Antibody testing was obtained using cell-based assay. The primary analyses of interest investigated differences in low-contrast visual acuity stratified by the defined RNFL ranges and by antibody positivity. Results: We analyzed 28 eyes from 14 anti-MOG ab patients (MOG-ON cohort), 18 eyes from 9 anti-AQP4 ab (AQP4-ON cohort) patients and 26 eyes from 13 patients who tested negative for both the antibodies (seronegative ON cohort). MOG-ON eyes with zero reported clinical events had lower RNFL thickness, than the minimum RNFL thickness of either the seronegative-ON or AQP4-ON eyes with zero clinical attacks in most retinal segments. Within the lowest range of the RNFL (RNFL <50 um) in most retinal segments, the MOG-ON cohort had a statistically significant greater visual acuity relative to the AQP4 cohort. Conclusions: Patients with anti-MOG antibody mediated CNS disorders can suffer from subclinical ON events with significant reductions in RNFL. Despite equally significant damage to the optic nerve, MOG-Ab positive patients have relatively preserved visual acuity.
AB - Background: Optic nerve involvement in anti-myelin oligodendrocyte glycoprotein antibody associated syndrome (MOG ab syndrome) tends to have unique features. Few studies have reported optical coherence tomography (OCT) measures like retinal nerve fiber layer thickness findings in the setting of pediatric MOG ab syndrome. Objectives: The aim of this study is to compare visual acuity between MOG ab positive and MOG ab negative pediatric cohorts and examine correlations with OCT findings. Methods: We included outpatients less than 18 years of age who had optic neuritis (ON) of at least one eye and who completed visual testing and OCT in the study. ON was defined based on clinical or OCT findings. Antibody testing was obtained using cell-based assay. The primary analyses of interest investigated differences in low-contrast visual acuity stratified by the defined RNFL ranges and by antibody positivity. Results: We analyzed 28 eyes from 14 anti-MOG ab patients (MOG-ON cohort), 18 eyes from 9 anti-AQP4 ab (AQP4-ON cohort) patients and 26 eyes from 13 patients who tested negative for both the antibodies (seronegative ON cohort). MOG-ON eyes with zero reported clinical events had lower RNFL thickness, than the minimum RNFL thickness of either the seronegative-ON or AQP4-ON eyes with zero clinical attacks in most retinal segments. Within the lowest range of the RNFL (RNFL <50 um) in most retinal segments, the MOG-ON cohort had a statistically significant greater visual acuity relative to the AQP4 cohort. Conclusions: Patients with anti-MOG antibody mediated CNS disorders can suffer from subclinical ON events with significant reductions in RNFL. Despite equally significant damage to the optic nerve, MOG-Ab positive patients have relatively preserved visual acuity.
KW - MOG
KW - Optic neuritis
KW - Optical coherence tomography
KW - Pediatric
KW - Retinal nerve fiber layer
KW - Visual acuity
UR - http://www.scopus.com/inward/record.url?scp=85058505825&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85058505825&partnerID=8YFLogxK
U2 - 10.1016/j.msard.2018.11.026
DO - 10.1016/j.msard.2018.11.026
M3 - Article
C2 - 30576847
AN - SCOPUS:85058505825
VL - 28
SP - 86
EP - 90
JO - Multiple Sclerosis and Related Disorders
JF - Multiple Sclerosis and Related Disorders
SN - 2211-0348
ER -