Radiological differentiation of optic neuritis with myelin oligodendrocyte glycoprotein antibodies, aquaporin-4 antibodies, and multiple sclerosis. (April 2016)

• Record Type: Journal Article
• Authors: Ramanathan, Sudarshini; Prelog, Kristina; Barnes, Elizabeth H; Tantsis, Esther M; Reddel, Stephen W; Henderson, Andrew PD; Vucic, Steve; Gorman, Mark P; Benson, Leslie A; Alper, Gulay; Riney, Catherine J; Barnett, Michael; Parratt, John DE; Hardy, Todd A; Leventer, Richard J; Merheb, Vera; Nosadini, Margherita; Fung, Victor SC; Brilot, Fabienne; Dale, Russell C
• Is Part Of: Multiple sclerosis. Volume 22:Number 4(2016)
• Page Start: 470
• Page End: 482
• Publication Date: 2016-04
• Subjects: Optic neuritis -- neuromyelitis optica -- myelin oligodendrocyte glycoprotein antibodies -- aquaporin-4 antibodies -- multiple sclerosis -- radiology; Central nervous system -- Diseases -- Periodicals; Myelin sheath -- Diseases -- Periodicals; Inflammation -- Periodicals; Multiple sclerosis -- Periodicals; Central Nervous System Diseases -- Periodicals; Demyelinating Diseases -- Periodicals; Inflammation -- Periodicals; Multiple Sclerosis -- Periodicals; Système nerveux central -- Maladies -- Périodiques; Gaine de myéline -- Maladies -- Périodiques; Inflammation (Pathologie) -- Périodiques; Sclérose en plaques -- Périodiques; Electronic journals; 616.834005
• DOI: 10.1177/1352458515593406
• Languages: English
• ISSNs: 1352-4585

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.