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Letter
MRI and retinal abnormalities in isolated optic neuritis with myelin oligodendrocyte glycoprotein and aquaporin-4 antibodies: a comparative study
  1. Tetsuya Akaishi1,
  2. Douglas Kazutoshi Sato2,3,
  3. Ichiro Nakashima1,
  4. Takayuki Takeshita4,
  5. Toshiyuki Takahashi1,5,
  6. Hiroshi Doi4,
  7. Kazuhiro Kurosawa1,
  8. Kimihiko Kaneko1,
  9. Hiroshi Kuroda1,
  10. Shuhei Nishiyama1,
  11. Tatsuro Misu2,
  12. Toru Nakazawa4,
  13. Kazuo Fujihara2,
  14. Masashi Aoki1
  1. 1 Department of Neurology, Tohoku University School of Medicine, Sendai, Japan
  2. 2 Department of Multiple Sclerosis Therapeutics, Tohoku University Graduate School of Medicine, Sendai, Japan
  3. 3 Department of Neurology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
  4. 4 Department of Ophthalmology, Tohoku University School of Medicine, Sendai, Japan
  5. 5 Department of Neurology, Yonezawa National Hospital, Yonezawa, Japan
  1. Correspondence to Dr Douglas Kazutoshi Sato, Department of Multiple Sclerosis Therapeutics, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi Aoba-ku, Sendai, Miyagi 980-8574, Japan; douglas.sato{at}med.tohoku.ac.jp

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Introduction

Acute optic neuritis (ON) typically presents with ocular pain and low visual acuity (VA), and there is a risk of permanent vision loss if ON is not managed properly.1 ON may be the first symptom of inflammatory diseases of the central nervous system (CNS), such as multiple sclerosis and neuromyelitis optica spectrum disorder (NMOSD).

Recently, we reported some distinct characteristics between seropositive anti-aquaporin-4 (anti-AQP4) patients and seropositive antimyelin oligodendrocyte glycoprotein (anti-MOG) patients with NMOSD, using our in-house cell-based assays (CBA). However, patients with a single attack of unilateral ON were not included in our previous study. None of the previous studies of anti-MOG+ patients performed orbital MRI or optical coherence tomography (OCT) segmentation analyses, which may have diagnostic and prognostic implications. To address these issues, we evaluated the diagnostic utility of the anti-MOG assay and compared the MRI and OCT findings of anti-MOG+ and anti-AQP4+ patients with isolated ON.

Patients and methods

Patients

We investigated 28 affected ON eyes from 21 consecutive anti-AQP4 seronegative patients aged 12 years or older who presented with isolated ON (4 cases with simultaneous bilateral ON, 3 cases with relapsing unilateral ON, and 14 cases with a single attack of unilateral ON) and were admitted to Tohoku University Hospital between 2011 and 2013. We excluded patients with ON already associated with brain and/or spinal cord MRI lesions. We compared anti-MOG+ ON eyes with nine affected ON eyes from eight anti-AQP4+ patients with isolated ON (one simultaneous bilateral ON). Severe VA loss was set at 0.1 in the decimal Japanese chart (equivalent to 20/200).2

Orbital MRI

All patients performed orbital imaging using a 1.5 T MRI. We measured the short τ inversion recovery (STIR) and/or T2-weighted image hyperintense lesions …

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