Clinical Characteristics of Pediatric Optic Neuritis With Myelin Oligodendrocyte Glycoprotein Seropositive: A Cohort Study

Pediatr Neurol. 2018 Jun;83:42-49. doi: 10.1016/j.pediatrneurol.2018.03.003. Epub 2018 Mar 13.

Abstract

Background: The clinical characteristics of patients with pediatric optic neuritis with seropositive myelin oligodendrocyte glycoprotein antibodies in Asia have not been reported.

Methods: Patients ≤18 years-old with acute-onset optic neuritis were enrolled. Serum myelin oligodendrocyte glycoprotein and aquaporin-4 antibodies were detected and patients were followed for at least six months. The clinical features were evaluated among myelin oligodendrocyte glycoprotein-seropositive optic neuritis, aquaporin-4-seropositive optic neuritis, and double seronegative optic neuritis. Best-corrected visual acuity, thickness of optic disc retinal nerve fiber layer, and macular ganglion cell complex were measured by optical coherence tomography.

Results: Among myelin oligodendrocyte glycoprotein-optic neuritis, aquaporin-4-optic neuritis, and seronegative-optic neuritis, the percentages of best-corrected visual acuity measured better than 0.8 (20/25) at the six-month visit were 89.47%, 33.33%, and 82.26%, respectively, a rate that is significantly better in patients with myelin oligodendrocyte glycoprotein-optic neuritis and seronegative-optic neuritis (P = 0.02). The average peripapillary retinal nerve fiber layers were 58.03 ± 8.73 µm, 64.34 ± 12.88 µm, and 78.12 ± 13.34 µm for the patients with myelin oligodendrocyte glycoprotein-optic neuritis, aquaporin-4-optic neuritis, and seronegative-optic neuritis, respectively, which showed no statistical difference between patients with myelin oligodendrocyte glycoprotein-optic neuritis and aquaporin-4-optic neuritis (P = 0.089), but were both thinner than patients with seronegative-optic neuritis (P = 0.001).

Conclusions: The recovery of visual acuity in patients with myelin oligodendrocyte glycoprotein-optic neuritis was as good as in patients with seronegative-optic neuritis, and the retinal nerve fiber layer of the optic nerve head showed thinning as severe as that of the patients with aquaporin-4-optic neuritis.

Keywords: Aquaporin-4 (AQP4); Myelin oligodendrocyte glycoprotein (MOG); Neuromyelitis optica (NMO); Optic neuritis; Pediatric.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Aquaporin 4 / immunology*
  • Autoantibodies / blood*
  • Child
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Myelin-Oligodendrocyte Glycoprotein / immunology*
  • Optic Neuritis / blood*
  • Optic Neuritis / diagnostic imaging*
  • Optic Neuritis / physiopathology*
  • Tomography, Optical Coherence

Substances

  • AQP4 protein, human
  • Aquaporin 4
  • Autoantibodies
  • MOG protein, human
  • Myelin-Oligodendrocyte Glycoprotein