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Neuro-inflammation
Original research
Time to steroids impacts visual outcome of optic neuritis in MOGAD
  1. Julie Rode1,
  2. Julie Pique2,
  3. Adil Maarouf1,3,
  4. Xavier Ayrignac4,
  5. Bertrand Bourre5,
  6. Jonathan Ciron6,
  7. Mikael Cohen7,
  8. Nicolas Collongues8,
  9. Romain Deschamps9,
  10. Elisabeth Maillart10,
  11. Alexis Montcuquet11,
  12. Caroline Papeix9,
  13. Aurelie Ruet11,
  14. Sandrine Wiertlewski12,
  15. Helene Zephir13,
  16. Romain Marignier2,
  17. Bertrand Audoin1,3
  1. 1Service de neurologie, Hôpital de la Timone, APHM, Marseille, France
  2. 2Service de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron, France
  3. 3CRMBM UMR 7339, CNRS, Aix-Marseille University, Marseille, France
  4. 4INM, Inserm, Department of Neurology CHU Montpellier, University of Montpellier, Montpellier, France
  5. 5Neurology, CHU de Rouen, Rouen, France
  6. 6Department of Neurology, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
  7. 7Service de Neurologie, Hôpital Pasteur, Nice, France
  8. 8Neurologie, Hôpital de Hautepierre, Strasbourg, France
  9. 9Neurology, Hôpital Fondation Adolphe de Rothschild, Paris, France
  10. 10Neurology, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
  11. 11Department of Neurology, CHU de Bordeaux, Bordeaux, France
  12. 12Service de Neurologie, CHU Nantes, Nantes, France
  13. 13Department of Neurology, Inserm U 1172, Centre hospitalier universitaire de Lille, Univ-Lille, Lille, France
  1. Correspondence to Julie Rode, Service de Neurologie, Hôpital de la Timone, APHM, Marseille, France; julie.rode{at}ap-hm.fr

Abstract

Background To characterise the response to treatment of inaugural optic neuritis (ON) in patients with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD).

Methods We searched the French MOGAD database for adults with inaugural ON with a detailed report of acute treatment modalities and measures of high-contrast best-corrected visual acuity (BCVA) at nadir and after 3 months. Predictors of visual outcomes were assessed by multivariable analysis.

Results Among 245 patients with at least one episode of ON, 82 fulfilled all criteria, and data on the peripapillary retinal nerve fibre layer (pRNFL) were available for 44. All patients received methylprednisolone (MP), combined with plasma exchange in 18. After 3 months, 75 of 82 (91%) patients retained full BCVA recovery, and median (range) pRNFL of the affected eye was 72 µm (40–102). Failure to regain 0.0 logarithmic minimum angle of resolution vision (Snellen 20/20) at 3 months was associated with time to first MP treatment ≥10 days (OR 16, 95% CI 1.14 to 213, p=0.01). pRNFL thickness after 3 months was related to better BCVA at nadir and time to first MP treatment <10 days (r2=19%, p=0.004 and r2=11%, p=0.03, respectively).

Conclusions Time to MP affects functional but also structural visual outcomes of ON in MOGAD.

  • NEUROOPHTHALMOLOGY
  • NEUROIMMUNOLOGY
  • VISION
  • CLINICAL NEUROLOGY

Data availability statement

Data are available on reasonable request.

https://doi.org/10.1136/jnnp-2022-330360

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    Data availability statement

    Data are available on reasonable request.

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    Footnotes

    • Contributors JR played a major role in the acquisition of the data and the gathering of data. JP played a major role in the acquisition of the data. AM played a major role in the acquisition of the data. XA played a major role in the acquisition of the data. BB played a major role in the acquisition of the data. JC played a major role in the acquisition of the data. NC played a major role in the acquisition of the data. MC played a major role in the acquisition of the data. NC played a major role in the acquisition of the data. RD played a major role in the acquisition of the data. EM played a major role in the acquisition of the data. AM played a major role in the acquisition of the data. CP played a major role in the acquisition of the data. AR played a major role in the acquisition of the data. SW played a major role in the acquisition of the data. HZ played a major role in the acquisition of the data. RM planned the study and played a major role in the acquisition of the data. BA planned and conducted the study, conducted statistical analysis and wrote the manuscript. BA is the guarantor of the study.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

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

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.