title: Retinal Nerve Fiber Layer May Be Better Preserved in MOG-IgG versus AQP4-IgG Optic Neuritis: A Cohort Study.
abstract: BACKGROUND
  Optic neuritis (ON) in patients with anti-myelin oligodendrocyte glycoprotein (MOG)-IgG antibodies has been associated with a better clinical outcome than anti-aquaporin 4 (AQP4)- IgG ON. Average retinal nerve fiber layer thickness (RNFL) correlates with visual outcome after ON.
  
  
  OBJECTIVE
  The aim of this study was to examine whether anti-MOG-IgG ON is associated with better average RNFL compared to anti-AQP4-IgG ON, and whether this corresponds with a better visual outcome.
  
  
  METHODS
  A retrospective study was done in a consecutive cohort of patients following anti-AQP4-IgG and anti-MOG-IgG ON. A generalized estimating equation (GEE) models analysis was used to compare average RNFL outcomes in ON eyes of patients with MOG-IgG to AQP4-IgG-positive patients, after adjusting for the number of ON events. The final mean visual field defect and visual acuity were compared between ON eyes of MOG-IgG and AQP4-IgG-positive patients. A correlation between average RNFL and visual function was performed in all study eyes.
  
  
  RESULTS
  Sixteen patients were analyzed; ten AQP4-IgG-positive and six MOG-IgG-positive. The six patients with MOG-IgG had ten ON events with disc edema, five of which were bilateral. In the AQP4-IgG-positive ON events, 1/10 patients had disc edema. Final average RNFL was significantly better in eyes following MOG-IgG-ON (75.33μm), compared to 63.63μm in AQP4-IgG-ON, after adjusting for the number of ON attacks (GEE, p = 0.023). Mean visual field defects were significantly smaller (GEE, p = 0.046) among MOG-IgG positive ON eyes compared to AQP-IgG positive ON eyes, but last visual acuity did not differ between the groups (GEE, p = 0.153). Among all eyes, average RNFL positively correlated with mean visual field defect (GEE, p = 0.00015) and negatively correlated with final visual acuity (GEE, p = 0.00005).
  
  
  CONCLUSIONS
  Following ON, RNFL is better preserved in eyes of patients with MOG-IgG antibodies compared to those with AQP4-IgG antibodies, correlating with better visual outcomes.
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.|Neuro-Ophthalmology Unit, Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Hadas
authors.identifier: http://orcid.org/0000-0001-7715-6706
authors.initials: H
authors.lastname: Stiebel-Kalish
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.|Neuro-Immunology Service and Department of Neurology, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Itay
authors.initials: I
authors.lastname: Lotan
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.|Neuro-Ophthalmology Unit, Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Judith
authors.initials: J
authors.lastname: Brody
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.|Department of Epidemiology and Preventive Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Chodick
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.|Neuro-Ophthalmology Unit, Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Omer
authors.initials: O
authors.lastname: Bialer
authors.affiliation: Service de Neurologie A, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon-Bron, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Marignier
authors.affiliation: Eye Center, Medical Center, University of Freiburg, Germany, and Faculty of Medicine, University of Freiburg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Bach
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.|Neuro-Immunology Service and Department of Neurology, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Mark Andrew
authors.initials: MA
authors.lastname: Hellmann
mesh_terms: D000328:Adult; D051401:Aquaporin 4 / Q000235:genetics / Q000276:immunology*; D001323:Autoantibodies / Q000096:biosynthesis; D002648:Child; D005260:Female; D015870:Gene Expression; D006801:Humans; D007074:Immunoglobulin G / Q000096:biosynthesis; D008875:Middle Aged; D063308:Myelin-Oligodendrocyte Glycoprotein / Q000235:genetics / Q000276:immunology*; D009413:Nerve Fibers, Myelinated / Q000276:immunology* / Q000473:pathology; D009900:Optic Nerve / Q000000981:diagnostic imaging* / Q000276:immunology / Q000473:pathology; D009902:Optic Neuritis / Q000000981:diagnostic imaging* / Q000276:immunology / Q000473:pathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014794:Visual Fields
chemical_list: C496030:AQP4 protein, human; D051401:Aquaporin 4; D001323:Autoantibodies; D007074:Immunoglobulin G; D063308:Myelin-Oligodendrocyte Glycoprotein