TY - JOUR T1 - Astrocytic outer retinal layer thinning is not a feature in AQP4-IgG seropositive neuromyelitis optica spectrum disorders JF - Journal of Neurology, Neurosurgery & Psychiatry JO - J Neurol Neurosurg Psychiatry SP - 188 LP - 195 DO - 10.1136/jnnp-2021-327412 VL - 93 IS - 2 AU - Angelo Lu AU - Hanna G Zimmermann AU - Svenja Specovius AU - Seyedamirhosein Motamedi AU - Claudia Chien AU - Charlotte Bereuter AU - Marco A Lana-Peixoto AU - Mariana Andrade Fontenelle AU - Fereshteh Ashtari AU - Rahele Kafieh AU - Alireza Dehghani AU - Mohsen Pourazizi AU - Lekha Pandit AU - Anitha D'Cunha AU - Ho Jin Kim AU - Jae-Won Hyun AU - Su-Kyung Jung AU - Letizia Leocani AU - Marco Pisa AU - Marta Radaelli AU - Sasitorn Siritho AU - Eugene F May AU - Caryl Tongco AU - Jérôme De Sèze AU - Thomas Senger AU - Jacqueline Palace AU - Adriana Roca-Fernández AU - Maria Isabel Leite AU - Srilakshmi M Sharma AU - Hadas Stiebel-Kalish AU - Nasrin Asgari AU - Kerstin Kathrine Soelberg AU - Elena H Martinez-Lapiscina AU - Joachim Havla AU - Yang Mao-Draayer AU - Zoe Rimler AU - Allyson Reid AU - Romain Marignier AU - Alvaro Cobo-Calvo AU - Ayse Altintas AU - Uygur Tanriverdi AU - Rengin Yildirim AU - Orhan Aktas AU - Marius Ringelstein AU - Philipp Albrecht AU - Ivan Maynart Tavares AU - Denis Bernardi Bichuetti AU - Anu Jacob AU - Saif Huda AU - Ibis Soto de Castillo AU - Axel Petzold AU - Ari J Green AU - Michael R Yeaman AU - Terry J Smith AU - Lawrence Cook AU - Friedemann Paul AU - Alexander U Brandt AU - Frederike Cosima Oertel A2 - , Y1 - 2022/02/01 UR - http://jnnp.bmj.com/content/93/2/188.abstract N2 - Background Patients with anti-aquaporin-4 antibody seropositive (AQP4-IgG+) neuromyelitis optica spectrum disorders (NMOSDs) frequently suffer from optic neuritis (ON) leading to severe retinal neuroaxonal damage. Further, the relationship of this retinal damage to a primary astrocytopathy in NMOSD is uncertain. Primary astrocytopathy has been suggested to cause ON-independent retinal damage and contribute to changes particularly in the outer plexiform layer (OPL) and outer nuclear layer (ONL), as reported in some earlier studies. However, these were limited in their sample size and contradictory as to the localisation. This study assesses outer retinal layer changes using optical coherence tomography (OCT) in a multicentre cross-sectional cohort.Method 197 patients who were AQP4-IgG+ and 32 myelin-oligodendrocyte-glycoprotein antibody seropositive (MOG-IgG+) patients were enrolled in this study along with 75 healthy controls. Participants underwent neurological examination and OCT with central postprocessing conducted at a single site.Results No significant thinning of OPL (25.02±2.03 µm) or ONL (61.63±7.04 µm) were observed in patients who were AQP4-IgG+ compared with patients who were MOG-IgG+ with comparable neuroaxonal damage (OPL: 25.10±2.00 µm; ONL: 64.71±7.87 µm) or healthy controls (OPL: 24.58±1.64 µm; ONL: 63.59±5.78 µm). Eyes of patients who were AQP4-IgG+ (19.84±5.09 µm, p=0.027) and MOG-IgG+ (19.82±4.78 µm, p=0.004) with a history of ON showed parafoveal OPL thinning compared with healthy controls (20.99±5.14 µm); this was not observed elsewhere.Conclusion The results suggest that outer retinal layer loss is not a consistent component of retinal astrocytic damage in AQP4-IgG+ NMOSD. Longitudinal studies are necessary to determine if OPL and ONL are damaged in late disease due to retrograde trans-synaptic axonal degeneration and whether outer retinal dysfunction occurs despite any measurable structural correlates.Data are available upon reasonable request. All authors commit to sharing anonymised data pertaining to this study to the BMJ as reasonably requested and subject to the ICMJE data sharing policy of 1 July 2018. ER -