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. 2020 Oct;26(11):1360-1371.
doi: 10.1177/1352458519864928. Epub 2019 Jul 31.

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  1 , Angeliki Filippatou  1 , Kathryn C Fitzgerald  1 , Sara Salama  2 , Santiago Pardo  1 , Jiangxia Wang  3 , Esther Ogbuokiri  1 , Norah J Cowley  1 , Nicole Pellegrini  1 , Olwen C Murphy  1 , Maureen A Mealy  1 , Jerry L Prince  4 , Michael Levy  1 , Peter A Calabresi  1 , Shiv Saidha  1
Affiliations

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 et al. Mult Scler. 2020 Oct.

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.

Keywords: Optic neuritis; multiple sclerosis; myelin oligodendrocyte glycoprotein; neuromyelitis optica; optical coherence tomography.

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Conflict of interest statement

CONFLICT OF INTEREST

The authors report no conflict of interest.

Figures

Figure 1.
Figure 1.. Study flowchart
Abbreviations: ON: optic neuritis; AQP4: aquaporin-4; MOG: myelin oligodendrocyte glycoprotein; MS: multiple sclerosis
Figure 2.
Figure 2.. Estimated HCLA by group and GCIPL thickness
Figure 2a demonstrates estimates (solid line) and 95% confidence intervals (shaded area) of HCLA by GCIPL thickness, separately for AQP4-ON (blue), MOG-ON (red) and MS-ON (green), derived from generalized estimating equations (GEE) model including ON group, GCIPL thickness and their interaction. Pearson correlation coefficients are shown for each group. Figure 2b shows, similarly derived, point estimates and 95% confidence intervals of HCLA by group at specific values of GCIPL thickness. P-values are shown for statistically significant comparisons between groups. Abbreviations: ON: optic neuritis; AQP4-ON: aquaporin-4-IgG seropositive ON; MOG-ON: myelin oligodendrocyte glycoprotein-IgG seropositive ON; MS-ON: multiple sclerosis ON; CI: confidence interval; GCIPL: ganglion cell+inner plexiform layer; HCLA: high-contrast letter-acuity
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References

    1. Wingerchuk DM, Hogancamp WF, O’Brien PC, et al. The clinical course of neuromyelitis optica (Devic’s syndrome). Neurology 1999; 53: 1107–14. - PubMed
    1. Merle H, Olindo S, Bonnan M, et al. Natural history of the visual impairment of relapsing neuromyelitis optica. Ophthalmology 2007; 114: 810–5. - PubMed
    1. Lennon VA, Kryzer TJ, Pittock SJ, et al. IgG marker of optic-spinal multiple sclerosis binds to the aquaporin-4 water channel. J Exp Med 2005; 202: 473–7. - PMC - PubMed
    1. Kitley J, Waters P, Woodhall M, et al. Neuromyelitis optica spectrum disorders with aquaporin-4 and myelin-oligodendrocyte glycoprotein antibodies: a comparative study. JAMA Neurol 2014; 71: 276–283. - PubMed
    1. Sato DK, Callegaro D, Lana-Peixoto MA, et al. Distinction between MOG antibody-positive and AQP4 antibody-positive NMO spectrum disorders. Neurology 2014; 82: 474–481. - PMC - PubMed

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