Clinical, imaging and follow-up study of optic neuritis associated with
myelin oligodendrocyte glycoprotein antibody: a multicentre study of
62 adult patients
N. Shor
a,b
, J. Aboab
c
, E. Maillart
d
, A. Lecler
b
, C. Bensa
e
, G. Le Guern
c
, S. Grunbaum
f
,
R. Marignier
g
, C. Papeix
d
, E. Heron
c
, O. Gout
e
, J. Savatovsky
b
, D. Galanaud
a
, C. Vignal
h
, V. Touitou
f
and
R. Deschamps
e
a
Department of Neuroradiology, Groupe Hospitalier Piti e-Salp^ etri ere, AP-HP, Paris;
b
Department of Neuroradiology, Fondation
Ophtalmologique Adolphe de Rothschild, Paris cedex;
c
Department of Internal Medicine, Centre Hospitalier National d’ophtalmologie des
Quinze-Vingts, Paris;
d
Department of Neurology, Groupe Hospitalier Piti e-Salp^ etri ere, AP-HP, Paris;
e
Department of Neurology,
Fondation Ophtalmologique Adolphe de Rothschild, Paris cedex;
f
Department of Ophthalmology, Groupe Hospitalier Piti e-Salp^ etri ere,
AP-HP, Paris;
g
Department of Neurology, H^ opital Neurologique Pierre Wertheimer Hospices Civils de Lyon, Bron; and
h
Department of
Neuro-Ophthalmology, Fondation Ophtalmologique Adolphe de Rothschild, Paris cedex, France
Keywords:
follow-up, MRI, myelin
oligodendrocyte
glycoprotein, optic
neuritis
Received 9 April 2019
revision requested 2 July 2019
Accepted 3 September 2019
European Journal of
Neurology 2019, 0: 1–8
doi:10.1111/ene.14089
Abstract
Background and purpose: There are few clinico-radiological data on optic neu-
ritis (ON) with myelin oligodendrocyte glycoprotein antibody (MOG-IgG).
The objective was to characterize the clinico-radiological phenotype and out-
come of patients with MOG-IgG-related ON.
Methods: The records of all adult patients admitted in three medical centres
with MOG-IgG-associated ON who underwent orbital and brain magnetic res-
onance imaging (MRI) at the acute phase were reviewed. Spinal cord MRI
within 1 month from the ON and all of the follow-up MRI were reviewed.
Results: Of 62 patients, 41.9% had bilateral ON and 66.2% optic disc swel-
ling. On initial MRI, lesions were anterior (92%), extensive (63%) and associ-
ated with optic perineuritis (46.6%). Silent brain lesions were found in 51.8%
of patients but were mainly non-specific (81%). Of 39 individuals with spinal
MRI at onset, nine had abnormal findings (four were asymptomatic). Two
symptomatic patients had longitudinally extensive myelitis with concurrent H-
sign. At last follow-up, 5% of patients had visual acuity ≤0.1. Brain MRI
remained unchanged in 41 patients (87%).
Conclusions: Our study supports a mostly benign ophthalmological course of
MOG-IgG-associated ON, despite initially longitudinally extensive lesions and
development of optic nerve atrophy on orbital MRI. Spinal MRI could be of
interest in detecting silent suggestive lesions.
Introduction
Optic neuritis (ON) is a frequent neurological mani-
festation of inflammatory central nervous system
(CNS) disease, most commonly caused by multiple
sclerosis (MS). Recently described [1] myelin oligoden-
drocyte glycoprotein antibody (MOG-IgG) associated
disease (MOGAD) is the second cause of
demyelinating ON and should now be considered. A
population-based prospective study included 51
patients referred with a diagnosis of ON, of whom
4% had MOG-IgG [2]. Amongst adult patients, ON
is the most common manifestation revealing MOGAD
[3].
Only sparse data are available regarding the radio-
logical features of MOG-IgG-associated ON. More-
over, the populations described often include both
paediatric and adult patients [4–6], with different clini-
cal phenotypes (ON, myelitis and encephalitis) [3],
Correspondence: N. Shor, Department of Neuroradiology, Piti e-
Salp^ etri ere Hospital, 83 bd de l’H^ opital, 75013 Paris, France (tel.:
+33661884335; fax: 0142163515; e-mail: shor.natalia@icloud.com).
© 2019 European Academy of Neurology 1
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