Myelin-oligodendrocyte-glycoprotein (MOG) autoantibodies as potential markers of severe optic neuritis and subclinical retinal axonal degeneration

• Published in: Journal of neurology Vol. 264; no. 1; pp. 139 - 151
• Main Authors: Havla, Joachim, Kümpfel, T., Schinner, R., Spadaro, M., Schuh, E., Meinl, E., Hohlfeld, R., Outteryck, O.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.01.2017; Springer Nature B.V
• Subjects: Adult; Anti-N-Methyl-D-Aspartate Receptor Encephalitis - diagnostic imaging; Anti-N-Methyl-D-Aspartate Receptor Encephalitis - immunology; Antibodies; Aquaporin 4 - immunology; Aquaporins; Autoantibodies - blood; Biomarkers - metabolism; Disease; Edema; Encephalitis; Encephalomyelitis; Encephalomyelitis - diagnostic imaging; Encephalomyelitis - immunology; Female; Follow-Up Studies; Glycoproteins; Humans; Macular Edema - diagnostic imaging; Macular Edema - immunology; Male; Medicine; Medicine & Public Health; Middle Aged; Multiple sclerosis; Multiple Sclerosis, Relapsing-Remitting - diagnostic imaging; Multiple Sclerosis, Relapsing-Remitting - immunology; Myelin-Oligodendrocyte Glycoprotein - immunology; Neurology; Neuromyelitis Optica - diagnostic imaging; Neuromyelitis Optica - immunology; Neuroradiology; Neurosciences; Optic Nerve - diagnostic imaging; Optic Neuritis - diagnostic imaging; Optic Neuritis - immunology; Optics; Original Communication; Retina - diagnostic imaging; Tomography; Tomography, Optical Coherence; France; Germany; Myelin-oligodendrocyte-glycoprotein; Multiple sclerosis; Neuromyelitis optica spectrum disorder; Optical coherence tomography; Microcystic macular edema
• ISSN: 0340-5354; 1432-1459
• DOI: 10.1007/s00415-016-8333-7

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.