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Chronic relapsing inflammatory optic neuropathy (CRION): a manifestation of myelin oligodendrocyte glycoprotein antibodies.
J Neuroinflammation 2018; 15(1):302JN

Abstract

BACKGROUND

Key clinical features of chronic relapsing inflammatory optic neuropathy (CRION) include relapsing inflammatory optic neuritis (ON) and steroid dependency, both of which have been reported among patients with myelin oligodendrocyte glycoprotein antibodies (MOG-Abs). We investigated the relevance of the presence of serum MOG-IgG with the current diagnostic criteria for CRION among patients with idiopathic inflammatory optic neuritis (iON).

METHODS

Retrospective reviews of a database prospectively collated between 2011 and 2017 from the tertiary referral center for multiple sclerosis and neuromyelitis optica were performed. Sixty-four patients with iON, who did not meet the diagnostic criteria for multiple sclerosis, neuromyelitis optica (NMO) spectrum disorder with/without NMO-IgG, or acute disseminated encephalomyelitis and who had no symptomatic central nervous system (CNS) lesions other than on the optic nerve, were included from a cohort of 615 patients with inflammatory demyelinating diseases of the CNS. Fulfillment of the current diagnostic criteria for CRION, assay results for the serum IgG1 MOG-Ab, and characteristics of CRION patients with MOG-IgG were compared to those of non-CRION patients with MOG-IgG.

RESULTS

Twelve iON patients fulfilled the current diagnostic criteria for CRION, 11 patients were positive for MOG-IgG, and one patient was borderline. Among the other 52 iON patients not meeting the criteria for CRION, 14 had relapsing disease courses and 38 had monophasic courses, of which MOG-IgG positivity were 0% and 29%, respectively. CRION patients with MOG-IgG had more relapsing disease courses (first steroid-dependent worsening/relapse in 2.3 months, range 0.4-7.0) and poorer optical coherence tomography outcomes at follow-up than non-CRION patients with MOG-IgG. However, patients in the two groups did not differ in terms of age of onset, sex, or steroid treatment duration after initial attack.

CONCLUSIONS

CRION, according to the current diagnostic criteria, is a relapsing optic neuritis associated with MOG-IgG. Among iON patients with MOG-IgG, the absence of steroid-dependent attacks in the early stages of the disease may predict a long-term non-relapsing disease course and a more favorable outcome.

Authors+Show Affiliations

Department of Ophthalmology, College of Medicine, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, 110-744, Republic of Korea.Department of Neurology, College of Medicine, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, 110-744, Republic of Korea.Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK.Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK.Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK.Department of Neurology, College of Medicine, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, 110-744, Republic of Korea.Department of Ophthalmology, College of Medicine, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, 110-744, Republic of Korea. ophjun@gmail.com.Department of Neurology, College of Medicine, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, 110-744, Republic of Korea. sueh916@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30382857

Citation

Lee, Haeng-Jin, et al. "Chronic Relapsing Inflammatory Optic Neuropathy (CRION): a Manifestation of Myelin Oligodendrocyte Glycoprotein Antibodies." Journal of Neuroinflammation, vol. 15, no. 1, 2018, p. 302.
Lee HJ, Kim B, Waters P, et al. Chronic relapsing inflammatory optic neuropathy (CRION): a manifestation of myelin oligodendrocyte glycoprotein antibodies. J Neuroinflammation. 2018;15(1):302.
Lee, H. J., Kim, B., Waters, P., Woodhall, M., Irani, S., Ahn, S., ... Kim, S. M. (2018). Chronic relapsing inflammatory optic neuropathy (CRION): a manifestation of myelin oligodendrocyte glycoprotein antibodies. Journal of Neuroinflammation, 15(1), p. 302. doi:10.1186/s12974-018-1335-x.
Lee HJ, et al. Chronic Relapsing Inflammatory Optic Neuropathy (CRION): a Manifestation of Myelin Oligodendrocyte Glycoprotein Antibodies. J Neuroinflammation. 2018 Oct 31;15(1):302. PubMed PMID: 30382857.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chronic relapsing inflammatory optic neuropathy (CRION): a manifestation of myelin oligodendrocyte glycoprotein antibodies. AU - Lee,Haeng-Jin, AU - Kim,Boram, AU - Waters,Patrick, AU - Woodhall,Mark, AU - Irani,Sarosh, AU - Ahn,Sohyun, AU - Kim,Seong-Joon, AU - Kim,Sung-Min, Y1 - 2018/10/31/ PY - 2018/06/08/received PY - 2018/10/16/accepted PY - 2018/11/2/entrez PY - 2018/11/2/pubmed PY - 2018/12/19/medline KW - Chronic relapsing inflammatory optic neuropathy KW - Multiple sclerosis KW - Myelin oligodendrocyte glycoprotein antibodies KW - Neuromyelitis optica KW - Optic neuritis SP - 302 EP - 302 JF - Journal of neuroinflammation JO - J Neuroinflammation VL - 15 IS - 1 N2 - BACKGROUND: Key clinical features of chronic relapsing inflammatory optic neuropathy (CRION) include relapsing inflammatory optic neuritis (ON) and steroid dependency, both of which have been reported among patients with myelin oligodendrocyte glycoprotein antibodies (MOG-Abs). We investigated the relevance of the presence of serum MOG-IgG with the current diagnostic criteria for CRION among patients with idiopathic inflammatory optic neuritis (iON). METHODS: Retrospective reviews of a database prospectively collated between 2011 and 2017 from the tertiary referral center for multiple sclerosis and neuromyelitis optica were performed. Sixty-four patients with iON, who did not meet the diagnostic criteria for multiple sclerosis, neuromyelitis optica (NMO) spectrum disorder with/without NMO-IgG, or acute disseminated encephalomyelitis and who had no symptomatic central nervous system (CNS) lesions other than on the optic nerve, were included from a cohort of 615 patients with inflammatory demyelinating diseases of the CNS. Fulfillment of the current diagnostic criteria for CRION, assay results for the serum IgG1 MOG-Ab, and characteristics of CRION patients with MOG-IgG were compared to those of non-CRION patients with MOG-IgG. RESULTS: Twelve iON patients fulfilled the current diagnostic criteria for CRION, 11 patients were positive for MOG-IgG, and one patient was borderline. Among the other 52 iON patients not meeting the criteria for CRION, 14 had relapsing disease courses and 38 had monophasic courses, of which MOG-IgG positivity were 0% and 29%, respectively. CRION patients with MOG-IgG had more relapsing disease courses (first steroid-dependent worsening/relapse in 2.3 months, range 0.4-7.0) and poorer optical coherence tomography outcomes at follow-up than non-CRION patients with MOG-IgG. However, patients in the two groups did not differ in terms of age of onset, sex, or steroid treatment duration after initial attack. CONCLUSIONS: CRION, according to the current diagnostic criteria, is a relapsing optic neuritis associated with MOG-IgG. Among iON patients with MOG-IgG, the absence of steroid-dependent attacks in the early stages of the disease may predict a long-term non-relapsing disease course and a more favorable outcome. SN - 1742-2094 UR - https://www.unboundmedicine.com/medline/citation/30382857/Chronic_relapsing_inflammatory_optic_neuropathy__CRION_:_a_manifestation_of_myelin_oligodendrocyte_glycoprotein_antibodies_ L2 - https://jneuroinflammation.biomedcentral.com/articles/10.1186/s12974-018-1335-x DB - PRIME DP - Unbound Medicine ER -