The use of OCT in good visual acuity MOGAD and AQP4-NMOSD patients; with and without optic neuritis
Open accessAbstract
Myelin oligodendrocyte-antibody-associated disease (MOGAD) often presents with severe optic neuritis (ON) but tends to recover better than in aquaporin-4 antibody neuromyelitis optica spectrum disorder (AQP4-NMOSD). We measured OCT and VEP in MOGAD and AQP4-NMOSD eyes with good visual function, with or without previous ON episodes. Surprisingly, OCT and/or VEPs were abnormal in 84% MOGAD-ON versus 38% AQP4-NMOSD-ON eyes (p = 0.009) with good vision, compared with 18% and 17% respectively of eyes with no previous ON. A sub-group with macular OCT performed as part of a research study confirmed both retinal and macular defects in visually-recovered MOGAD eyes. These findings have implications for investigation and management of MOGAD patients.
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People with NMOSD and MOGAD with known prior optic neuritis often have lower pRNFL and GCIPL thicknesses than people with multiple sclerosis who have had prior optic neuritis.
“The degrees of pRNFL and GCIPL thinning present may also be informative, since people with NMOSD and MOGAD with known prior ON often have lower pRNFL and GCIPL thicknesses than PwMS who have had prior ON. 84 -87”
From The use of optical coherence tomography and visual evoked potentials in the 2024 McDonald diagnostic criteria for multiple sclerosis (2025) · cites this paper as [84]
The Results (Macular sub-study cohort; page not provided) report lower pRNFL and GCIP measurements in MOGAD eyes with prior optic neuritis than in healthy controls. The study includes AQP4-NMOSD patients, but our copy does not establish the claimed thickness comparison for that group. It includes no multiple-sclerosis comparator, so it cannot support the claim that either disease group has lower thicknesses than people with MS after optic neuritis. (LLM, conf=0.87)
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Research works printed but not linked: 6
- [1]Jurynczyk M Messina S Woodhall MR, et al. Clinical presentation and prognosis in MOG-antibody disease: a UK study. Brain J Neurol 2017; 01): 3128– 3138. 29136091
- [2]Fujihara K Misu T Nakashima I, et al. Neuromyelitis optica should be classified as an astrocytopathic disease rather than a demyelinating disease. Clin Exp Neuroimmunol 2012; 3: 58– 73.
- [3]Filippatou AG Mukharesh L Saidha S, et al. AQP4-IgG And MOG-IgG related optic neuritis—prevalence, optical coherence tomography findings, and visual outcomes: a systematic review and meta-analysis. Front Neurol [Internet], 2020 Oct 8; 11:540156. doi: 10.3389/fneur.2020.540156. PMC7578376 33132999 · DOI
- [4]Cobo-Calvo A Ruiz A Maillart E, et al. Clinical spectrum and prognostic value of CNS MOG autoimmunity in adults: the MOGADOR study. Neurology 2018 May 22; 90: e1858– e1869. 29695592
- [5]Kitley J Leite MI Nakashima I, et al. Prognostic factors and disease course in aquaporin-4 antibody-positive patients with neuromyelitis optica spectrum disorder from the United Kingdom and Japan. Brain J Neurol 2012 Jun; 135: 1834– 1849. 22577216
- [6]Sotirchos ES Filippatou A Fitzgerald KC, et al. Aquaporin-4 IgG seropositivity is associated with worse visual outcomes after optic neuritis than MOG-IgG seropositivity and multiple sclerosis, independent of macular ganglion cell layer thinning. Mult Scler J 2020 Oct 1; 26: 1360– 1371. PMC6992495 31364464
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Saidha, S., Green, A. J., Leocani, L., Vidal-Jordana, A., Kenney, R. C., Bsteh, G., Outteryck, O., Thompson, A., Montalban, X., Coetzee, T., et al. (2025) · The Lancet Neurology · doi:10.1016/s1474-4422(25)00275-3 · Cited by 66 · see citing works
- Authors
- Roca-Fernández, A., Camera, V, Loncarevic-Whitaker, G., Messina, S., Mariano, R., Vincent, A., Sharma, S., Leite, M., & Palace, J.
- Affiliations
- Nuffield Department of Clinical Neuroscience, University Of Oxford, UK
- University of Oxford (GB)
- National Health Service (GB)
- Corresponding author
- Palace, J
- Venue
- Multiple Sclerosis Journal - Experimental, Translational and Clinical
- Publisher
- SAGE Publications
- Published
- 2021-10
- Volume
- 7
- Issue
- 4
- Pages
- 20552173211066446-20552173211066446
- ISSN
- 2055-2173 (ISSN-L)
- PMC
- PMC8752955
- OpenAlex
- W4200273111
- Cited by
- 12
- References
- 0
- Citations by year
- 2025: 4 · 2024: 2 · 2023: 4 · 2022: 2
- FWCI
- 1.33
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Multiple Sclerosis Journal - Experimental Translational and Clinical (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Medical Research Council (MR/T024682/1)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Ophthalmology › Glaucoma and retinal disorders
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Keywords
- myelin oligodendrocyte glycoprotein antibody-associated disease, optic neuritis, optical coherence tomography, visual evoked potentials, retinal defects, visual acuity, multiple sclerosis
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