Initial Data Can Inform Diagnostic Assessment of MOGAD-Related Optic Neuritis

Initial data on patient demographics and clinical presentation may assist in informing clinical practice for the diagnostic assessment of optic neuritis related to myelin oligodendrocyte godendrocyte glycoprotein antibody-associated disease (MOGAD), according to study results presented at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2023, held in San Diego, California, from February 23 to 25.

“[T]his is the first study that describes the demographic and clinical presentation of MOGAD ON [optic neuritis] in a Canadian population,” according to researchers.

Optic neuritis refers to inflammation and swelling of the optic nerve, causing eye pain and visual disturbances. It often occurs in the context of widespread central nervous system inflammation as seen in the context of multiple sclerosis, but it may occur sporadically.

Determining the underlying etiology behind cases of optic neuritis can be challenging as evidenced by the various known subtypes of optic neuritis. Identification of specific serum biomarkers, such as MOG immunoglobulin G (IgC) autoantibodies and aquaporin-4 (AQP) IgG, allows for differentiation between causes of optic neuritis such as MOGAD or neuromyelitis optica spectrum disorders (NMOSD), respectively.

Researchers in Canada conducted a retrospective, observational study from 2008 to 2022, detailing the demographics and clinical presentation of 20 patients who received a final diagnosis of MOGAD optic neuritis after neuro-ophthalmic evaluation and serum testing at a tertiary care center in Calgary, Alberta.

In this patient cohort, 11 (55%) individuals were female, while the remaining 9 (45%) were male. Ages ranged between 4.4 to 52.8 years old with an average age of 34.4 years.

Clinical presentations at time of initial evaluation included ocular pain in 14 patients (70%), bilateral optic neuritis in 8 patients (40%), and relative afferent pupillary defects in 17 patients (85%).

Based on ocular examination and ancillary testing results, visual acuity was best-corrected between light perception and 20/25. Optical coherence tomography indicated a range of baseline retinal nerve fiber layer values measuring between 111 to 422 micrometers (µm).

The researchers concluded, “This data establishes statistical evidence to inform clinical practice and prioritize investigations in the workup of ON. Continuing analysis of follow-up will likely delineate treatment efficacy and identify prognostic factors for visual outcomes.”

This article originally appeared on Neurology Advisor