Sudarshini Ramanathan1, Kristina Prelog2, Elizabeth H Barnes3, Esther M Tantsis4, Stephen W Reddel5, Andrew P D Henderson6, Steve Vucic7, Mark P Gorman8, Leslie A Benson8, Gulay Alper9, Catherine J Riney10, Michael Barnett11, John D E Parratt12, Todd A Hardy13, Richard J Leventer14, Vera Merheb4, Margherita Nosadini4, Victor S C Fung15, Fabienne Brilot4, Russell C Dale16. 1. 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. 2. Department of Medical Imaging, the Children's Hospital at Westmead, Sydney, Australia. 3. NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia. 4. 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. 5. Department of Neurology, Concord Repatriation General Hospital, Sydney, Australia/Brain and Mind Research Institute, University of Sydney, Sydney, Australia. 6. Department of Neurology, Westmead Hospital, and Sydney Medical School, University of Sydney, Sydney, Australia/Department of Ophthalmology, Westmead Hospital, Sydney, Australia. 7. Department of Neurology, Westmead Hospital, and Sydney Medical School, University of Sydney, Sydney, Australia/Western Clinical School, University of Sydney, Sydney, Australia. 8. Boston Children's Hospital, Boston, United States of America. 9. Children's Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh, School of Medicine, Pittsburgh, United States of America. 10. Neurosciences Unit, Lady Cilento Children's Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia. 11. Brain and Mind Research Institute, University of Sydney, Sydney, Australia/Department of Neurology, Royal Prince Alfred Hospital, Sydney, Australia. 12. Department of Neurology, Royal North Shore Hospital, Central Clinical School, University of Sydney, Sydney, Australia. 13. Brain and Mind Research Institute, University of Sydney, Sydney, Australia/Department of Neurology, Concord Repatriation General Hospital, Sydney, Australia. 14. Department of Neurology, University of Melbourne Department of Paediatrics, Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia. 15. Department of Neurology, Westmead Hospital, and Sydney Medical School, University of Sydney, Sydney, Australia. 16. 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.
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.
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: S Jarius; F Paul; O Aktas; N Asgari; R C Dale; J de Seze; D Franciotta; K Fujihara; A Jacob; H J Kim; I Kleiter; T Kümpfel; M Levy; J Palace; K Ruprecht; A Saiz; C Trebst; B G Weinshenker; B Wildemann Journal: Nervenarzt Date: 2018-12 Impact factor: 1.214
Authors: Sven Jarius; Klemens Ruprecht; Ingo Kleiter; Nadja Borisow; Nasrin Asgari; Kalliopi Pitarokoili; Florence Pache; Oliver Stich; Lena-Alexandra Beume; Martin W Hümmert; Marius Ringelstein; Corinna Trebst; Alexander Winkelmann; Alexander Schwarz; Mathias Buttmann; Hanna Zimmermann; Joseph Kuchling; Diego Franciotta; Marco Capobianco; Eberhard Siebert; Carsten Lukas; Mirjam Korporal-Kuhnke; Jürgen Haas; Kai Fechner; Alexander U Brandt; Kathrin Schanda; Orhan Aktas; Friedemann Paul; Markus Reindl; Brigitte Wildemann Journal: J Neuroinflammation Date: 2016-09-27 Impact factor: 8.322
Authors: Joachim Havla; T Kümpfel; R Schinner; M Spadaro; E Schuh; E Meinl; R Hohlfeld; O Outteryck Journal: J Neurol Date: 2016-11-14 Impact factor: 4.849