Background/aims To investigate the clinical features of Chinese patients with seropositive myelin oligodendrocyte glycoprotein antibody (MOG-Ab) optic neuritis (ON) and patients with seropositive aquaporin-4 antibody (AQP4-Ab) ON.
Methods In this retrospective observational study, sera from patients with demyelinating ON were tested for MOG-Ab and AQP4-Ab with a cell-based assay. Clinical characteristics were compared between MOG-Ab-related ON (MOG-ON) and AQP4-Ab-related ON (AQP4-ON), including visual performances, serum autoantibodies and features on MRI.
Results A total of 109 affected eyes from 65 patients with demyelinating ON (20 MOG-ON and 45 AQP4-ON) were included. The onset age of MOG-ON was younger than AQP4-ON (MOG-ON: 20.2±17.4 years old, AQP4-ON: 35.6±15.7 years old, P=0.001). Onset severity was not different between these two groups (P=0.112), but patients with MOG-ON showed better visual outcomes (P=0.004). Half of the MOG-ON had a relapsing disease course. Nineteen per cent of patients with AQP4-ON presented coexisting autoimmune disorders, but there were no coexisting autoimmune disorders among patients with MOG-ON. Optic nerve head swelling was more prevalent in patients with MOG-ON (P<0.01). Retrobulbar segment involvement of the optic nerve were more common in patients with MOG-ON according to our MRI findings (P<0.01). Patients with MOG-ON showed longitudinally extensive lesion in 30% and chiasm and optic tract involvement in 5%.
Conclusions MOG-ON is not rare in Chinese demyelinating patients. It underwent a severe vision loss at onset but had relatively better visual recovery than patients with AQP4-ON. MOG-ON might have an unique pathogenesis different from AQP4-ON.
- optic neuritis
- myelin oligodendrocyte glycoprotein antibody
- aquaporin-4 antibody
- clinical features
- visual performances
- magnetic resonance imaging
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YZ and ST contributed equally.
Contributors YZ and ST: study design, manuscript draft and revision, data collection and statistical analysis. TCYC: study design and manuscript revision. QX: study design and manuscript revision. JZ, DT and HF: study design and data collection. SW: study design, correspondence and manuscript revision.
Funding National High TechnologyResearch and Development Program of China (863 Program) 2015AA020511 and 59th China Postdoctoral Science Foundation 2016M592983.
Competing interests None declared.
Patient consent Obtained.
Ethics approval The institutional review board at the Chinese PLAGH.
Provenance and peer review Not commissioned; externally peer reviewed.
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