Abstract Details

Title MOG-IgG is associated with better visual outcomes after optic neuritis than AQP4-IgG seropositivity, despite similar severity of inner retinal layer thinning

Topic Autoimmune Neurology

Presentation(s) S21 - Autoimmune Neurology: Novel Diagnostic and Predictive Biomarkers and Immunopathologic Mechanisms of Disease (4:58 PM-5:09 PM)

Poster/Presentation
Number 009

Objective To compare visual outcomes and retinal optical coherence tomography (OCT) measures following optic neuritis (ON) associated with anti-aquaporin-4 IgG (AQP4-ON) and anti-myelin-oligodendrocyte-glycoprotein IgG (MOG-ON).

Background ON is a frequent manifestation of neuromyelitis optica spectrum disorders (NMOSD) and is often associated with poor visual outcomes and severe inner retinal layer thinning, as identified by OCT. The majority of cases of NMOSD are associated with AQP4-IgG. However, antibodies against MOG have been identified in a subset of NMOSD patients that are seronegative for AQP4-IgG. Studies comparing visual outcomes and OCT measures in AQP4-ON and MOG-ON are limited.

Design/Methods 16 MOG-ON, 48 AQP4-ON and 31 healthy control (HC) participants underwent retinal imaging with spectral-domain OCT. Monocular high-contrast letter-acuity (HCLA) was assessed. Only eyes with a history of ON greater than 3 months prior to the time of assessment were included in the analysis.

Results MOG-ON eyes (n=27) had better HCLA than AQP4-ON eyes (n=74; p<0.001), but both were decreased compared to HC eyes (n=62; p=0.02 and p<0.001, respectively). Retinal nerve fiber layer (RNFL) and ganglion cell+inner plexiform layer (GCIP) thicknesses were markedly decreased in MOG-ON (RNFL:60.9±11.2µm; GCIP:56.8±6.4µm) and AQP4-ON (RNFL:67.5±15.6µm; GCIP:55.5±10.8µm) compared to HC eyes (RNFL:91.3±10.0µm; GCIP:75.9±4.7µm; p<0.001), but did not differ between MOG-ON and AQP4-ON eyes. Microcystoid macular pathology (MMP) was found in 3 MOG-ON (11%) and 14 AQP4-ON (19%) eyes. Presence of MMP was associated with worse HCLA, and lower RNFL and GCIP thicknesses (p≤0.001 for all). Multivariate analyses, including demographic variables, presence of MMP, number of ON episodes, and RNFL or GCIP thickness, revealed that MOG-ON was independently associated with better HCLA (p<0.001).

Conclusions Compared with AQP-4ON, MOG-IgG seropositivity is associated with better visual outcomes after ON, independent of RNFL/GCIP thinning and presence of MMP. These data suggest that additional pathologic processes may contribute to visual dysfunction in AQP4-ON.

Authors/Disclosures
Elias S. Sotirchos, MD (Johns Hopkins University) PRESENTER	Dr. Sotirchos has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Sotirchos has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Sotirchos has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Sotirchos has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. The institution of Dr. Sotirchos has received research support from National Institutes of Health. The institution of Dr. Sotirchos has received research support from National Multiple Sclerosis Society. The institution of Dr. Sotirchos has received research support from Sumaira Foundation. The institution of Dr. Sotirchos has received research support from Genentech. The institution of Dr. Sotirchos has received research support from UCB. The institution of Dr. Sotirchos has received research support from Astoria Biologica. The institution of Dr. Sotirchos has received research support from Ad Scientiam. The institution of Dr. Sotirchos has received research support from Alexion. The institution of Dr. Sotirchos has received research support from Corevitas. Dr. Sotirchos has received personal compensation in the range of $500-$4,999 for serving as a Ad Hoc Reviewer with National Institutes of Health.
Angeliki Filippatou, MD (Johns Hopkins University School of Medicine)	Dr. Filippatou has nothing to disclose.
Sara Salama, MBBS	Dr. Salama has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Merck. Dr. Salama has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Novartis. Dr. Salama has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Roche. Dr. Salama has received personal compensation in the range of $0-$499 for serving as a Speaker with Sumaira Foundation.
	No disclosure on file
Maureen A. Mealy, PhD, RN	No disclosure on file
Kathryn Fitzgerald, PhD (Johns Hopkins University)	The institution of Dr. Fitzgerald has received research support from NIH. The institution of Dr. Fitzgerald has received research support from National MS Society.
Olwen Murphy, MD (Johns Hopkins Hospital)	Dr. Murphy has nothing to disclose.
	No disclosure on file
Jerry Prince	No disclosure on file
Michael Levy, MD, PhD, FAAN (Massachusetts General Hospital/Harvard Medical School)	Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mitsubishi Pharma. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB Pharma. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Levy has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various law firms. The institution of Dr. Levy has received research support from National Institutes Health.
Peter A. Calabresi, MD, FAAN (Johns Hopkins University)	Dr. Calabresi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Calabresi has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lilly. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Idorsia. An immediate family member of Dr. Calabresi has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MyMD. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Myelin Repair Foundation. The institution of Dr. Calabresi has received research support from Genentech. Dr. Calabresi has received publishing royalties from a publication relating to health care. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Study Section Member with NIH. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Grant reveiwer with Myelin Repair Foundation. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Speaker for CME with NYAS. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Academic CME.
Shiv Saidha, MD (Johns Hopkins)	Dr. Saidha has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ReWind Therapeutics. Dr. Saidha has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Saidha has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Saidha has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Clene Pharmaceuticals. Dr. Saidha has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Saidha has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Saidha has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Saidha has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Multiple Sclerosis Journal ETC. Dr. Saidha has stock in June Brain. Dr. Saidha has stock in Lapix Therapeutics. The institution of Dr. Saidha has received research support from Biogen. The institution of Dr. Saidha has received research support from Genentech. The institution of Dr. Saidha has received research support from Novartis. The institution of Dr. Saidha has received research support from Lapix Therapeutics. The institution of Dr. Saidha has received research support from Novartis.

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