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Optic Neuropathies Associated With Multiple Sclerosis (MS) and Neuromyelitis Optica Spectrum Disorders (NMO-SD)
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
NMO-SD as discussed is most frequently associated with anti-AQP4-IgG antibodies. Damage to myelin oligodendrocyte glycoprotein (MOG), which is expressed on the surfaces of oligodendrocytes and myelin sheath causes anti-MOG syndromes. The presence of anti-MOG IgG antibodies may cause clinical syndrome similar to NMO-SD. Of special interest is the ON related to MOG IgG antibodies, which is the most common presentation of anti-MOG syndromes and is present in about 60% of cases. Forty percent of AQP-4 sero-negative optico spinal syndromes have been found to have MOG IgG antibody disease (29). Myelitis is the next most frequent presentation and cerebral changes, and rarely may manifest as ADEM -like syndrome or encephalitis or epilepsy. Like AqP4 antibody disease, MOG IgG associated ON is a female predominant disease and occurs more frequently in individuals older in age as compared to MSON (average age of onset approximately 40 years) and is a female predominant disease. Around 40% patients have bilateral disease and most present with prominent optic disc edema. About 80–93% have recurrent disease and this was considered to the most common antibody found in cases of chronic relapsing inflammatory optic neuropathy (CRION) (30). MOG IgG ON extensively involves the optic nerve along its whole length but less frequently extend up to optic chiasm. Involvement is predominantly anterior with comparative sparing of the intracranial optic nerve, optic chiasm and optic tract and the retro chiasmatic segment. Involvement of the optic nerve sheath and surrounding orbital fat may be present. This radiological picture with features of OPN may be seen more frequently than with AQP-4 antibody ON. The majority of patients with MOG IgG ON have a normal MRI of the brain. MOG antibody disease is less frequently associated with other autoimmune disease when compared with AQP-4 IgG ON. While vision loss is severe at presentation, recovery and overall prognosis tends to be better (7).
Neuro-Ophthalmic Literature Review
Published in Neuro-Ophthalmology, 2022
David A. Bellows, John J. Chen, Hui-Chen Cheng, Panitha Jindahra, Peter W. MacIntosh, Collin McClelland, Michael S. Vaphiades, Xiaojun Zhang
Baseline characteristic of the 28 participants who completed the entire study included a median age at enrolment of 10.3 years, 46% were female and 68% had unilateral optic neuritis at presentation. All of the patients were treated with corticosteroids, most within the first month of enrolment. Cerebral white matter changes were seen in 17/28 (61%) of the participants. Eight patients consented to optional myelin oligodendrocyte glycoprotein (MOG) and neuromyelitis optica (NMO) antibody testing. Three of these tested positive for anti-MOG and one for anti-NMO. The final diagnosis at 2 years based on magnetic resonance imaging and serological testing included 11 with isolated optic neuritis, eight with MOG antibody disease (MOGAD), four with multiple sclerosis (MS), two with acute disseminated encephalomyelitis (ADEM), and three with NMO spectrum disorder (NMOSD).
Upregulated Retinal Neurofilament Expression in Experimental Optic Neuritis
Published in Neuro-Ophthalmology, 2022
Robert Weissert, Therése Hugosson, Axel Petzold
The concentration of NfHSMI35 total protein in controls (0.93 μg/mg) was marginally lower than what is found in human brain control grey matter (1.15 μg/mg).17 Likewise, the concentration in the MOG-EAE ON retina of 4.29 NfHSMI35 total protein is marginally lower than what is found in the human MS grey matter (5.15 μg/mg; all data are median). This strengthens the argument on similarities between the experimental model and human post-mortem data.14 Finally, in human MOG antibody disease there were elevated Nf levels in the cerebrospinal fluid and serum of 14 cases with MOG-ON from a deep phenotyped cohort.18
Antibody Testing in Atypical Optic Neuritis
Published in Seminars in Ophthalmology, 2020
Melanie Truong-Le, Bart Chwalisz
MOG is a protein found on myelin sheaths on the cell body and processes of oligodendrocytes. MOG-IgG is found in 25% of patients meeting criteria for AQP4-seronegative NMOSD.24 These MOG-IgG seropositive patients, although described as having NMOSD, have been found to have distinct clinical features, and are now widely considered a separate disease.16,25,26 Names such as “MOG-antibody-related disorder,” “MOG-associated disease,” “MOG antibody disease,” or “MOG-positive NMOSD” have been used interchangeably with MOG-encephalomyelitis (MOG-EM), though the latter term has been recommended lately by an international working group.26