title: Myelin-oligodendrocyte-glycoprotein (MOG) autoantibodies as potential markers of severe optic neuritis and subclinical retinal axonal degeneration.
abstract: Antibodies against conformation-dependent epitopes of myelin-oligodendrocyte-glycoprotein (MOG-abs) are present in subgroups of neuromyelitis optica spectrum disorder (NMOSD), recurrent optic neuritis (rON), multiple sclerosis (MS), and anti-NMDAR encephalitis. Using optical coherence tomography (OCT) we assessed whether MOG-abs might serve as potential marker of retinal axonal degeneration. We investigated a clinically heterogeneous cohort of 13 MOG-abs-positive patients (4 MOG-abs-positive rON, 4 MOG-abs-positive adult MS, 3 MOG-abs-positive relapsing encephalomyelitis, 2 MOG-abs-positive aquaporin-4-abs-negative NMOSD). As controls, we studied 13 age, sex and ON episode(s)-matched MOG-abs and aquaporin-4-abs-negative (AQP4-abs-negative) MS patients and 13 healthy controls (HC). In addition, we investigated 19 unmatched AQP4-abs-positive MOG-abs-negative NMOSD subjects. Considering all eyes, global pRNFL [in µm, mean (SD)] was significantly reduced in MOG-abs-positive patients [72.56 (22.71)] compared to MOG-abs-negative MS [80.81 (13.55), p = 0.0128], HCs [103.54 (8.529), p = 0.0014] and NMOSD [88.32 (18.43), p = 0.0353]. Non ON eyes from MOG-abs-positive subjects showed significant subclinical atrophy of temporal pRNFL quadrants. Microcystic macular edema (MME) was observed only in eyes of MOG-abs-positive (24%) and AQP4-abs-positive NMOSD (5.6%), but not in MOG-abs-negative MS or HC (p < 0.01). MOG-abs may serve as potential marker of retinal degeneration. Specifically, MOG-abs-related OCT features predominate in temporal pRNFL quadrants (resembling the MS retinal pattern), might be more severe than AQP4-abs-positive NMOSD, indicate subclinical pathology, and may be associated with MME.
authors.affiliation: Institute of Clinical Neuroimmunology, Biomedical Center and University Hospital, Ludwig-Maximilians Universitaet Muenchen, Munich, Germany. joachim.havla@med.lmu.de.
authors.forename: Joachim
authors.initials: J
authors.lastname: Havla
authors.affiliation: Institute of Clinical Neuroimmunology, Biomedical Center and University Hospital, Ludwig-Maximilians Universitaet Muenchen, Munich, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Kümpfel
authors.affiliation: Institute of Clinical Radiology, Ludwig-Maximilians Universitaet Muenchen, Munich, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Schinner
authors.affiliation: Institute of Clinical Neuroimmunology, Biomedical Center and University Hospital, Ludwig-Maximilians Universitaet Muenchen, Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Spadaro
authors.affiliation: Institute of Clinical Neuroimmunology, Biomedical Center and University Hospital, Ludwig-Maximilians Universitaet Muenchen, Munich, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Schuh
authors.affiliation: Institute of Clinical Neuroimmunology, Biomedical Center and University Hospital, Ludwig-Maximilians Universitaet Muenchen, Munich, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Meinl
authors.affiliation: Institute of Clinical Neuroimmunology, Biomedical Center and University Hospital, Ludwig-Maximilians Universitaet Muenchen, Munich, Germany.|Munich Cluster for Systems Neurology, Munich, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Hohlfeld
authors.affiliation: Institute of Clinical Neuroimmunology, Biomedical Center and University Hospital, Ludwig-Maximilians Universitaet Muenchen, Munich, Germany.|Department of Neurology, Roger Salengro Hospital, University of Lille, Lille, France.
authors.forename: O
authors.initials: O
authors.lastname: Outteryck
mesh_terms: D000328:Adult; D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000000981:diagnostic imaging / Q000276:immunology; D051401:Aquaporin 4 / Q000276:immunology; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000378:metabolism; D004679:Encephalomyelitis / Q000000981:diagnostic imaging / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008269:Macular Edema / Q000000981:diagnostic imaging / Q000276:immunology; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000000981:diagnostic imaging / Q000276:immunology; D063308:Myelin-Oligodendrocyte Glycoprotein / Q000276:immunology*; D009471:Neuromyelitis Optica / Q000000981:diagnostic imaging / Q000276:immunology; D009900:Optic Nerve / Q000000981:diagnostic imaging; D009902:Optic Neuritis / Q000000981:diagnostic imaging* / Q000276:immunology*; D012160:Retina / Q000000981:diagnostic imaging*; D041623:Tomography, Optical Coherence
chemical_list: C496030:AQP4 protein, human; D051401:Aquaporin 4; D001323:Autoantibodies; D015415:Biomarkers; D063308:Myelin-Oligodendrocyte Glycoprotein
keywords: Microcystic macular edema; Multiple sclerosis; Myelin-oligodendrocyte-glycoprotein; Neuromyelitis optica spectrum disorder; Optical coherence tomography