title: Retinal segmented layers with strong aquaporin-4 expression suffered more injuries in neuromyelitis optica spectrum disorders compared with optic neuritis with aquaporin-4 antibody seronegativity detected by optical coherence tomography.
abstract: To evaluate retinal segmented layer alterations in optic neuritis (ON) in an AQP4-Ab seropositive (AQP4-Ab+/ON) cohort and in neuromyelitis optica (NMO) with ON eyes (NMO-ON) compared with an AQP4-Ab seronegative ON (AQP4-Ab-/ON) cohort using optical coherence tomography (OCT).
  
  
  
  We recruited 109 patients with ON (161 eyes) and 47 healthy controls. All patients with ON were subdivided into three subcohorts: 37 patients (54 eyes) with AQP4-Ab+/ON, 45 patients (65 eyes) with AQP4-Ab-/ON and 27 patients (42 eyes) with NMO-ON. All subjects were evaluated for their peripapillary retinal nerve fibre layer (pRNFL) and inner macular segmented layer using OCT.
  
  
  
  AQP4-Ab+/patients with ON had the same structural injury patterns as patients with NMO-ON, and the injury patterns were distinct from those of AQP4-Ab-/patients with ON. NMO-ON and AQP4-Ab+/ON preferentially damaged the pRNFL (all p=0.000), the macular retinal nerve fibre layer (mRNFL; p=0.000 and 0.032, respectively), and the inner plexiform layer (IPL; p=0.000 and 0.006, respectively) without differences in the retinal ganglion cell layer (p=0.106 and 0.374, respectively) compared with AQP4-Ab-/patients with ON. The thickness of the inner nuclear layer (INL) increased in NMO-ON (p=0.043) compared with that of AQP4-Ab-/ON without a significant difference in AQP4-Ab+/ON versus AQP4-Ab-/ON (p=0.353). When the thickness of the inferior nasal quadrant (NI) of the pRNFL was reduced to ≤46.5 μm (area under the curve 0.772, sensitivity 89.2% and specificity 57.5%) 6 months after ON onset, NMO was considered.
  
  
  
  AQP4-Ab+/ON produced similar structural injury patterns as NMO-ON. The pRNFL, mRNFL and IPL in the two types of ON and the INL in NMO-ON suffered more damage than those in AQP4-Ab-/ON, which could be associated with strong aquaporin-4 expression. The thickness of the NI of the pRNFL could be a potential clue for predicting ON progression to definite NMO.
authors.affiliation: Department of Ophthalmology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Chun Xia
authors.initials: CX
authors.lastname: Peng
authors.affiliation: Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors.forename: Hong Yang
authors.initials: HY
authors.lastname: Li
authors.affiliation: Zhongshan Ophthalmic Center, Sun yat-sen University, Guangzhou, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Ophthalmology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Jun Qing
authors.initials: JQ
authors.lastname: Wang
authors.affiliation: Department of Ophthalmology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.affiliation: Neurology Department, Chinese PLA General Hospital, Beijing, China.
authors.forename: Quan Gang
authors.initials: QG
authors.lastname: Xu
authors.affiliation: Department of Ophthalmology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Shan Shan
authors.initials: SS
authors.lastname: Cao
authors.affiliation: Department of Ophthalmology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Huan Fen
authors.initials: HF
authors.lastname: Zhou
authors.affiliation: Department of Ophthalmology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Shuo
authors.initials: S
authors.lastname: Zhao
authors.affiliation: Department of Ophthalmology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Shi Hui
authors.initials: SH
authors.lastname: Wei
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D051401:Aquaporin 4 / Q000276:immunology / Q000378:metabolism*; D001323:Autoantibodies / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers; D009471:Neuromyelitis Optica / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D009902:Optic Neuritis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D012160:Retina / Q000000981:diagnostic imaging / Q000378:metabolism; D012164:Retinal Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D041623:Tomography, Optical Coherence; D055815:Young Adult
chemical_list: D051401:Aquaporin 4; D001323:Autoantibodies
keywords: Diagnostic tests/Investigation; Imaging; Optic Nerve; Pathology; Retina