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  • MRI and retinal abnormalities in isolated optic neuritis with myelin oligodendrocyte glycoprotein and aquaporin-4 antibodies: a comparative study

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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

https://doi.org/10.1136/jnnp-2014-310206

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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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    Footnotes

    • Contributors TA, DKS and IN contributed to the study design and conceptualisation. TA, DKS, IN and KF drafted the manuscript. TA, DKS, IN, TaT, ToT, HD, KKu, KKa, HK, SN, TM, TN, KF and MA contributed to the acquisition, analysis and interpretation of data. TA, DKS and IN contributed to the statistical analysis. TA, DKS, IN, TaT, ToT, HD, KKu, KKa, HK, SN, TM, TN, KF and MA contributed to a critical revision of the manuscript.

    • Funding This study was supported by KAKENHI (22229008) of The Ministry of Education, Culture, Sports, Science and Technology (MEXT) of Japan, and by the Health and Labour Sciences Research Grant on Intractable Diseases (Neuroimmunological Diseases) from the Ministry of Health, Labour and Welfare of Japan.

    • Competing interests DKS has received a scholarship from the Ministry of Education, Culture, Sports, Science and Technology (MEXT) of Japan, research support from CAPES/Brasil and the Ichiro Kanehara Foundation, and speaker honoraria from Novartis. IN reports grants from the Ministry of Education, Culture, Sports, Science and Technology of Japan and from the Ministry of Health, Labour and Welfare of Japan, personal fees from Mitsubishi Tanabe Pharma Corporation, Biogen Idec Japan, Novartis Pharmaceuticals Japan, Bayer Yakuhin, Ltd, and grants from LSI Medience Corporation. HK reports grants from the Ministry of Education, Culture, Sports, Science and Technology of Japan. SN reports grant from JSPS KAKENHI Grant (Grant-in-Aid for Research Activity Start-up) Number 24890017. TM has received speaker honoraria from Bayer Schering Pharma, Biogen Idec Japan, Mitsubishi Tanabe Pharma Corporation, Asahi Kasei Medical Co., and Astellas Pharma Inc. and research support from Bayer Schering Pharma, Biogen Idec Japan, Asahi Kasei Kuraray Medical Co., The Chemo-Sero-Therapeutic Research Institute, Teva Pharmaceutical K.K., Mitsubishi Tanabe Pharma Corporation, Teijin Pharma, and Grants-in-Aid for Scientific Research from the Ministry of Education, Science and Technology, and the Ministry of Health, Labor and Welfare of Japan. KF has received funding for travel and speaker honoraria from Bayer Schering Pharma, Biogen Idec, Eisai Inc., Mitsubishi Tanabe Pharma Corporation, Novartis Pharma, Astellas Pharma Inc., Takeda Pharmaceutical Company Limited, Asahi Kasei Medical Co., Daiichi Sankyo, and Nihon Pharmaceutical and research support from Bayer Schering Pharma, Biogen Idec Japan, Asahi Kasei Medical, The Chemo-Sero-Therapeutic Research Institute, Teva Pharmaceutical, Mitsubishi Tanabe Pharma, Teijin Pharma, Chugai Pharmaceutical, Ono Pharmaceutical, Nihon Pharmaceutical, and Genzyme Japan; he is funded as the secondary investigator (#22229008, 2010–2015) by the Grants-in-Aid for Scientific Research from the Ministry of Education, Science and Technology of Japan and as the secondary investigator by the Grants-in-Aid for Scientific Research from the Ministry of Health, Welfare and Labor of Japan (2010-present).

    • Patient consent Obtained.

    • Ethics approval Tohoku University Hospital.

    • Provenance and peer review Not commissioned; externally peer reviewed.