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Neuromyelitis optica spectrum disorders and anti-myelin oligodendrocyte glycoprotein positive optic neuropathies

International Journal of Ophthalmology(English edition) 2022年第7期15卷 1095-1107页

作者： Patrick Murtagh Amy Coman Kirk Stephenson Maria Gaughan David Ryan Graeme McNeill Christopher McGuigan Lorraine Cassidy Royal Victoria Eye and Ear Hospital Adelaide RoadDublin 2D02 XK51Republic of Ireland St Vincent’s University Hospital Elm ParkDublin 4D04 N2E0Republic of Ireland

AIM: To describe the clinical characteristics and treatments associated with antibody positive optic neuropathies including anti-myelin oligodendrocyte glycoprotein(MOG) and anti-aquaporin 4(AQP4), alongside diagnostic modalities, investigations, and outcomes. METHODS: A cross-sectional single-centre retrospective case series consisting of 16 patients including 12 antiMOG positive patients and 4 anti-AQP4 positive patients. Each of these patients had clinical signs and symptoms of optic neuritis and consisted of all patients who had a positive blood antibody result in our centre. Clinical findings including presence of a relative afferent pupillary defect, colour vision and disc assessment were recorded. Structured clinical exam and multimodal imaging was undertaken sequentially on each. Optical coherence tomography(OCT) scanning was preformed to examine the correlation between ganglion cell layer(GCL) thickness and visual acuity(VA) at presentation and as a determinant of final visual outcome in both groups. Initial and long-term treatment is also summarised. RESULTS: A total of 16 patients were included in the study consisting of 12 anti-MOG and 4 anti-AQP4 positive patients. Nine of the 16 patients were female and the average age of onset was 29.2 y in the MOG group and 42 y in the AQP4 group. There was no statistically significant correlation(Pearson correlation) between GCL thickness and presenting and final VA [r(10)=0.081, P=0.08 and r(10)=0.089, P=0.34 respectively]. The same statistical analysis was performed for the correlation between retinal nerve fibre layer(RNFL) and VA and similar outcomes wereobserved [r(10)=0.04, P=0.22 and r(10)=0.09, P=0.04]. No correlation was seen for initial RNFL thickness and final visual outcome in this group either [r(2)=0.19, P=0.38]. Visual field testing and radiological findings for each group are described. CONCLUSION: No correlation between initial VA or RNFL and final visual outcome is identified. A broad range of visu

关键词： neuromyelitis anti-myelin oligodendrocyte glycoprotein antibody anti-aquaporin 4

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