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Frequency of Asymptomatic Optic Nerve Enhancement in 203 Patients With MOG Antibody-Associated Disease
Open accessAbstract
BACKGROUND AND OBJECTIVES: Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a distinct CNS demyelinating disease. The rate of asymptomatic optic nerve enhancement on MRI has not been explored in patients with MOGAD. An improved understanding of this would guide clinical practice and assessment of treatment efficacy. We aimed to determine the frequency of asymptomatic optic nerve enhancement in MOGAD. METHODS: This was a retrospective review of patients evaluated at Mayo Clinic with MOGAD between January 1, 2000, and August 1, 2021 (median follow-up 1.6 [range 1-19] years). MRI studies were reviewed by masked neuroradiologists. Scans performed within 30 days of ON attack were classified as attack scans. Images obtained for routine surveillance, before ON attack, or at the time of non-ON attack were classified as interattack scans. RESULTS: Five hundred sixty-six MRIs (203 unique patients, 53% female) were included. Interattack MRIs represented 341 (60%) of the scans (median 36 days post-ON [range -1,032 to 6,001]). Of the interattack scans, 43 of 341 (13%), 30 unique patients, showed optic nerve enhancement. The enhancement was located at prior sites of ON in 35 of 43 (81%). Among the 8 patients with enhancement in new optic nerve areas, 6 had acute disseminated encephalomyelitis without an eye examination at the time of the MRI and 2 had preceding ON without imaging. Long-term visual outcomes showed no significant difference between those with and without asymptomatic enhancement, with improved visual acuity in most patients. DISCUSSION: Asymptomatic optic nerve enhancement occurred in 13% of interattack MRIs, the majority in patients with prior ON and occurring at prior sites of optic nerve enhancement. New asymptomatic optic nerve enhancement in areas without prior ON was rare. These findings are important for understanding the natural history of MOGAD, the interpretation of symptoms or response to treatment, and the adjudication of attacks in clinical trials.
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“Of note, asymptomatic optic nerve lesions detected with MRI are rarely seen in NMOSD or MOGAD. 67,68”
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 [67]
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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
Metadata
- Authors
- Tajfirouz, D., Madhavan, A., Pacheco Marrero, J. M., Krecke, K. N., Fautsch, K. J., Flanagan, E. P., Pittock, S. J., Shah, S., Bhatti, M. T., & Chen, J. J.
- Affiliations
- Mayo Clinic (US)
- From the Department of Ophthalmology and Neurology (D.T.), Mayo Clinic; Department of Radiology (A.M., K.N.K.); Department of Ophthalmology (J.M.P.M., K.J.F.), Mayo Clinic; Department of Neurology (E.P.F.); Department of Neurology (S.J.P.), Center for MS and Autoimmune Neurology, Mayo Clinic, Rochester, MN; Department of Neurology (S.S.), Vanderbilt University Medical Center, Nashville, TN; The Permanente Medical Group, Department of Ophthalmology (M.T.B.), Kaiser Permanente-Northern California,...
- Corresponding author
- Chen, John J.
- ORCID
- Venue
- Neurology Neuroimmunology & Neuroinflammation
- Published
- 2024-09
- Volume
- 11
- Issue
- 5
- Pages
- e200277-e200277
- ISSN
- 2332-7812 (ISSN-L)
- PMC
- PMC11216805
- OpenAlex
- W4400030333
- Cited by
- 11
- References
- 0
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 1
- FWCI
- 3.34
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Neurology Neuroimmunology & Neuroinflammation (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Health Sciences › Medicine › Clinical Neurology › Peripheral Neuropathies and Disorders
- Keywords
- MOG antibody-associated disease, myelin oligodendrocyte glycoprotein, optic neuritis, demyelinating disease, acute disseminated encephalomyelitis, natural history (disease), visual outcome
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Autoantibodies, Child, Child, Preschool, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Optic Nerve, Retrospective Studies, Demyelinating Autoimmune Diseases, CNS, Young Adult, Asymptomatic Diseases, Myelin-Oligodendrocyte Glycoprotein
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