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Myelin Oligodendrocyte Glycoprotein Antibody–Positive Optic Neuritis: Clinical Characteristics, Radiologic Clues, and Outcome

Open access
Chen, John J., Flanagan, Eoin P., Jitprapaikulsan, Jiraporn, López-Chiriboga, Alfonso (Sebastian) S., Fryer, James P., Leavitt, Jacqueline A., Weinshenker, Brian G., McKeon, Andrew, Tillema, Jan-Mendelt, Lennon, Vanda A., Tobin, W. Oliver, Keegan, B. Mark, Lucchinetti, Claudia F., Kantarci, Orhun H., McClelland, Collin M., Lee, Michael S., Bennett, Jeffrey L., Pelak, Victoria S., Chen, Yanjun, VanStavern, Gregory, Adesina, Ore-Ofe O., Eggenberger, Eric R., Acierno, Marie D., Wingerchuk, Dean M., Brazis, Paul W., Sagen, Jessica, Pittock, Sean J.·2018·American Journal of Ophthalmology

Abstract

• PURPOSE: To characterize the clinical phenotype of myelin oligodendrocyte glycoprotein antibody (MOG-IgG) optic neuritis.• DESIGN: Observational case series.• METHODS: SETTING: Multicenter. PATIENT/STUDY POPULATION: Subjects meeting inclusion criteria: (1) history of optic neuritis; (2) seropositivity (MOG-IgG binding index > 2.5); 87 MOG-IgG-seropositive patients with optic neuritis were included (Mayo Clinic, 76; other medical centers, 11). MOG-IgG was detected using full-length MOG-transfected live HEK293 cells in a clinically validated flow cytometry assay. MAIN OUTCOME MEASURES: Clinical and radiologic characteristics and visual outcomes.• RESULTS: Fifty-seven percent were female and median age at onset was 31 (range 2–79) years. Median number of optic neuritis attacks was 3 (range 1–8), median follow-up 2.9 years (range 0.5–24 years), and annualized relapse rate 0.8. Average visual acuity (VA) at nadir of worst attack was count fingers. Average final VA was 20/30; for 5 patients (6%) it was ≤20/200 in either eye. Optic disc edema and pain each occurred in 86% of patients. Magnetic resonance imaging showed perineural enhancement in 50% and longitudinally extensive involvement in 80%. Twenty-six patients (30%) had recurrent optic neuritis without other neurologic symptoms, 10 (12%) had single optic neuritis, 14 (16%) had chronic relapsing inflammatory optic neuropathy, and 36 (41%) had optic neuritis with other neurologic symptoms (most neuromyelitis optica spectrum disorder–like phenotype or acute disseminated encephalomyelitis). Only 1 patient was diagnosed with MS (MOG-IgG-binding index 2.8; normal range ≤ 2.5). Persistent MOG-IgG seropositivity occurred in 61 of 62 (98%). A total of 61% received long-term immunosuppressant therapy.• CONCLUSIONS: Manifestations of MOG-IgG-positive optic neuritis are diverse. Despite recurrent attacks with severe vision loss, the majority of patients have significant recovery and retain functional vision long-term.

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Authors
Chen, J. J., Flanagan, E. P., Jitprapaikulsan, J., López-Chiriboga, A. (. S., Fryer, J. P., Leavitt, J. A., Weinshenker, B. G., McKeon, A., Tillema, J.-M., Lennon, V. A., Tobin, W. O., Keegan, B. M., Lucchinetti, C. F., Kantarci, O. H., McClelland, C. M., Lee, M. S., Bennett, J. L., Pelak, V. S., Chen, Y., VanStavern, G., Adesina, O.-O. O., Eggenberger, E. R., Acierno, M. D., Wingerchuk, D. M., Brazis, P. W., Sagen, J., & Pittock, S. J.
Venue
American Journal of Ophthalmology
Publisher
Elsevier BV
Published
2018-11
Volume
195
Pages
8-15
ISSN
0002-9394 (ISSN-L)
OpenAlex
W2883344170
Cited by
408
References
29
FWCI
26.19
Type
journal article
Language
en
Open access
green

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CoChat. (2026). Citation check: Myelin Oligodendrocyte Glycoprotein Antibody–Positive Optic Neuritis: Clinical Characteristics, Radiologic Clues, and Outcome. https://app.cochat.ai/papers/10.1016/j.ajo.2018.07.020
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Chen, J. J., Flanagan, E. P., Jitprapaikulsan, J., López-Chiriboga, A. (. S., Fryer, J. P., Leavitt, J. A., Weinshenker, B. G., McKeon, A., Tillema, J.-M., Lennon, V. A., Tobin, W. O., Keegan, B. M., Lucchinetti, C. F., Kantarci, O. H., McClelland, C. M., Lee, M. S., Bennett, J. L., Pelak, V. S., Chen, Y., . . . Pittock, S. J. (2018). Myelin Oligodendrocyte Glycoprotein Antibody–Positive Optic Neuritis: Clinical Characteristics, Radiologic Clues, and Outcome. American Journal of Ophthalmology. https://doi.org/10.1016/j.ajo.2018.07.020

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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.