Aquaporin-4 IgG seropositivity is associated with worse visual outcomes after optic neuritis than MOG-IgG seropositivity and multiple sclerosis, independent of macular ganglion cell layer thinning

Elias S. Sotirchos, Angeliki Filippatou, Kathryn C. Fitzgerald, Sara Salama, Santiago Pardo, Jiangxia Wang, Esther Ogbuokiri, Norah J. Cowley, Nicole Pellegrini, Olwen C. Murphy, Maureen A. Mealy, Jerry L. Prince, Michael Levy, Peter A. Calabresi, Shiv Saidha

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Background: Comparative studies of characteristics of optic neuritis (ON) associated with myelin oligodendrocyte glycoprotein-IgG (MOG-ON) and aquaporin-4-IgG (AQP4-ON) seropositivity are limited. Objective: To compare visual and optical coherence tomography (OCT) measures following AQP4-ON, MOG-ON, and multiple sclerosis associated ON (MS-ON). Methods: In this cross-sectional study, 48 AQP4-ON, 16 MOG-ON, 40 MS-ON, and 31 healthy control participants underwent monocular letter-acuity assessment and spectral-domain OCT. Eyes with a history of ON >3 months prior to evaluation were analyzed. Results: AQP4-ON eyes exhibited worse high-contrast letter acuity (HCLA) compared to MOG-ON (−22.3 ± 3.9 letters; p < 0.001) and MS-ON eyes (−21.7 ± 4.0 letters; p < 0.001). Macular ganglion cell + inner plexiform layer (GCIPL) thickness was lower, as compared to MS-ON, in AQP4-ON (−9.1 ± 2.0 µm; p < 0.001) and MOG-ON (−7.6 ± 2.2 µm; p = 0.001) eyes. Lower GCIPL thickness was associated with worse HCLA in AQP4-ON (−16.5 ± 1.5 letters per 10 µm decrease; p < 0.001) and MS-ON eyes (−8.5 ± 2.3 letters per 10 µm decrease; p < 0.001), but not in MOG-ON eyes (−5.2 ± 3.8 letters per 10 µm decrease; p = 0.17), and these relationships differed between the AQP4-ON and other ON groups (p < 0.01 for interaction). Conclusion: AQP4-IgG seropositivity is associated with worse visual outcomes after ON compared with MOG-ON and MS-ON, even with similar severity of macular GCIPL thinning.

Original languageEnglish (US)
Pages (from-to)1360-1371
Number of pages12
JournalMultiple Sclerosis Journal
Volume26
Issue number11
DOIs
StatePublished - Oct 1 2020

Keywords

  • Optic neuritis
  • multiple sclerosis
  • myelin oligodendrocyte glycoprotein
  • neuromyelitis optica
  • optical coherence tomography

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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