Radiological differentiation of optic neuritis with myelin oligodendrocyte glycoprotein antibodies, aquaporin-4 antibodies, and multiple sclerosis

Recognizing the cause of optic neuritis (ON) affects treatment decisions and visual outcomes. We aimed to define radiological features of first-episode demyelinating ON. We performed blinded radiological assessment of 50 patients presenting with first-episode myelin oligodendrocyte glycoprotein (MOG...

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Bibliographic Details
Published in:Multiple sclerosis Vol. 22; no. 4; p. 470
Main 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
Format: Journal Article
Language:English
Published: England 01.04.2016
Subjects:
Adolescent
Adult
Age of Onset
Aquaporin 4 - immunology
Autoantibodies - blood
Biomarkers - blood
Child
Child, Preschool
Diagnosis, Differential
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Multiple Sclerosis - blood
Multiple Sclerosis - diagnostic imaging
Multiple Sclerosis - immunology
Myelin-Oligodendrocyte Glycoprotein - immunology
Optic Neuritis - blood
Optic Neuritis - diagnostic imaging
Optic Neuritis - immunology
Optic Tract - diagnostic imaging
Predictive Value of Tests
Retrospective Studies
Young Adult
myelin oligodendrocyte glycoprotein antibodies
aquaporin-4 antibodies
Optic neuritis
multiple sclerosis
radiology
neuromyelitis optica
ISSN:1477-0970, 1477-0970
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Summary:Recognizing the cause of optic neuritis (ON) affects treatment decisions and visual outcomes. We aimed to define radiological features of first-episode demyelinating ON. 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). 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. 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.
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ISSN:1477-0970
1477-0970
DOI:10.1177/1352458515593406