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Radiological differentiation of optic neuritis with myelin oligodendrocyte glycoprotein antibodies, aquaporin-4 antibodies, and multiple sclerosis.
Mult Scler. 2016 Apr; 22(4):470-82.MS

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.

Authors+Show Affiliations

Neuroimmunology group, Institute for Neuroscience and Muscle Research, The Kids Research Institute at the Children's Hospital at Westmead, Sydney Medical School, University of Sydney, Sydney, Australia/Department of Neurology, Westmead Hospital, and Sydney Medical School, University of Sydney, Sydney, Australia.Department of Medical Imaging, the Children's Hospital at Westmead, Sydney, Australia.NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia.Neuroimmunology group, Institute for Neuroscience and Muscle Research, The Kids Research Institute at the Children's Hospital at Westmead, Sydney Medical School, University of Sydney, Sydney, Australia.Department of Neurology, Concord Repatriation General Hospital, Sydney, Australia/Brain and Mind Research Institute, University of Sydney, Sydney, Australia.Department of Neurology, Westmead Hospital, and Sydney Medical School, University of Sydney, Sydney, Australia/Department of Ophthalmology, Westmead Hospital, Sydney, Australia.Department of Neurology, Westmead Hospital, and Sydney Medical School, University of Sydney, Sydney, Australia/Western Clinical School, University of Sydney, Sydney, Australia.Boston Children's Hospital, Boston, United States of America.Boston Children's Hospital, Boston, United States of America.Children's Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh, School of Medicine, Pittsburgh, United States of America.Neurosciences Unit, Lady Cilento Children's Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia.Brain and Mind Research Institute, University of Sydney, Sydney, Australia/Department of Neurology, Royal Prince Alfred Hospital, Sydney, Australia.Department of Neurology, Royal North Shore Hospital, Central Clinical School, University of Sydney, Sydney, Australia.Brain and Mind Research Institute, University of Sydney, Sydney, Australia/Department of Neurology, Concord Repatriation General Hospital, Sydney, Australia.Department of Neurology, University of Melbourne Department of Paediatrics, Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia.Neuroimmunology group, Institute for Neuroscience and Muscle Research, The Kids Research Institute at the Children's Hospital at Westmead, Sydney Medical School, University of Sydney, Sydney, Australia.Neuroimmunology group, Institute for Neuroscience and Muscle Research, The Kids Research Institute at the Children's Hospital at Westmead, Sydney Medical School, University of Sydney, Sydney, Australia.Department of Neurology, Westmead Hospital, and Sydney Medical School, University of Sydney, Sydney, Australia.Neuroimmunology group, Institute for Neuroscience and Muscle Research, The Kids Research Institute at the Children's Hospital at Westmead, Sydney Medical School, University of Sydney, Sydney, Australia.Neuroimmunology group, Institute for Neuroscience and Muscle Research, The Kids Research Institute at the Children's Hospital at Westmead, Sydney Medical School, University of Sydney, Sydney, Australia russell.dale@health.nsw.gov.au.

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26163068

Citation

Ramanathan, Sudarshini, et al. "Radiological Differentiation of Optic Neuritis With Myelin Oligodendrocyte Glycoprotein Antibodies, Aquaporin-4 Antibodies, and Multiple Sclerosis." Multiple Sclerosis (Houndmills, Basingstoke, England), vol. 22, no. 4, 2016, pp. 470-82.
Ramanathan S, Prelog K, Barnes EH, et al. Radiological differentiation of optic neuritis with myelin oligodendrocyte glycoprotein antibodies, aquaporin-4 antibodies, and multiple sclerosis. Mult Scler. 2016;22(4):470-82.
Ramanathan, S., Prelog, K., Barnes, E. H., Tantsis, E. M., Reddel, S. W., Henderson, A. P., Vucic, S., Gorman, M. P., Benson, L. A., Alper, G., Riney, C. J., Barnett, M., Parratt, J. D., Hardy, T. A., Leventer, R. J., Merheb, V., Nosadini, M., Fung, V. S., Brilot, F., & Dale, R. C. (2016). Radiological differentiation of optic neuritis with myelin oligodendrocyte glycoprotein antibodies, aquaporin-4 antibodies, and multiple sclerosis. Multiple Sclerosis (Houndmills, Basingstoke, England), 22(4), 470-82. https://doi.org/10.1177/1352458515593406
Ramanathan S, et al. Radiological Differentiation of Optic Neuritis With Myelin Oligodendrocyte Glycoprotein Antibodies, Aquaporin-4 Antibodies, and Multiple Sclerosis. Mult Scler. 2016;22(4):470-82. PubMed PMID: 26163068.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radiological differentiation of optic neuritis with myelin oligodendrocyte glycoprotein antibodies, aquaporin-4 antibodies, and multiple sclerosis. AU - Ramanathan,Sudarshini, AU - Prelog,Kristina, AU - Barnes,Elizabeth H, AU - Tantsis,Esther M, AU - Reddel,Stephen W, AU - Henderson,Andrew P D, AU - Vucic,Steve, AU - Gorman,Mark P, AU - Benson,Leslie A, AU - Alper,Gulay, AU - Riney,Catherine J, AU - Barnett,Michael, AU - Parratt,John D E, AU - Hardy,Todd A, AU - Leventer,Richard J, AU - Merheb,Vera, AU - Nosadini,Margherita, AU - Fung,Victor S C, AU - Brilot,Fabienne, AU - Dale,Russell C, Y1 - 2015/07/10/ PY - 2015/04/01/received PY - 2015/06/03/accepted PY - 2015/7/12/entrez PY - 2015/7/15/pubmed PY - 2016/12/20/medline KW - Optic neuritis KW - aquaporin-4 antibodies KW - multiple sclerosis KW - myelin oligodendrocyte glycoprotein antibodies KW - neuromyelitis optica KW - radiology SP - 470 EP - 82 JF - Multiple sclerosis (Houndmills, Basingstoke, England) JO - Mult. Scler. VL - 22 IS - 4 N2 - 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. SN - 1477-0970 UR - https://www.unboundmedicine.com/medline/citation/26163068/Radiological_differentiation_of_optic_neuritis_with_myelin_oligodendrocyte_glycoprotein_antibodies_aquaporin_4_antibodies_and_multiple_sclerosis_ L2 - http://journals.sagepub.com/doi/full/10.1177/1352458515593406?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -