Abstract Details

Title A Predictive Model for Triple Negative Optic Neuritis Patients: Identifying the Subset of Patients With Favorable Outcomes

Topic Multiple Sclerosis

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 20-007

Objective This study aimed to characterize triple-negative ON (TNON) cases and compare them to MS, MOGAD, and NMOSD.

Background A subset of optic neuritis (ON) patients remains seronegative for AQP4-IgG, MOG-IgG, and CSF oligoclonal bands (OCBs), complicating diagnosis and management. We refer to this group as triple-negative optic neuritis (TNON).

Design/Methods We retrospectively analyzed 103 patients with a first ON episode tested for AQP4-IgG, MOG-IgG, and OCBs, classifying them into MS (n=26), MOGAD (n=25), NMOSD (n=13), and TNON (n=39). TNON was further divided into evolving MS (evMS) and idiopathic TNON. A support vector machine (SVM) was used to classify TNON based on onset data.

Results TNON patients showed less optic disc edema and radiological involvement than MOGAD and responded more poorly to steroids. However, TNON had lower relapse rates and less need for chronic treatment than MS or NMOSD. SVM analysis revealed that most evMS cases clustered with MS, while idiopathic TNON aligned more closely with MOGAD.

Conclusions TNON is a heterogeneous entity encompassing both early MS and a distinct idiopathic subgroup. While clinical features alone could not differentiate these subgroups, our predictive model successfully stratified them at onset. Idiopathic TNON may reflect an undetected antibody-mediated process with a generally favorable prognosis.

Authors/Disclosures
Ariel Rechtman (Hadassah-Hebrew University Medical Center) PRESENTER	Ariel Rechtman has nothing to disclose.
Tal Friedman Korn, MD	Dr. Friedman Korn has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche.
Omri Zveik, MD	Mr. Zveik has nothing to disclose.
Sol Zamir, MD	Dr. Zamir has nothing to disclose.
Netta Levin, MD, PhD (Hadassah Hebrew University Hospital)	Dr. Levin has nothing to disclose.
Adi Vaknin-Dembinsky, MD	Dr. Vaknin-Dembinsky has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medison Pharma. Dr. Vaknin-Dembinsky has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for neopharm group. Dr. Vaknin-Dembinsky has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for medisone . Dr. Vaknin-Dembinsky has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for alexion.

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