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| Item Type: | Article |
|---|---|
| Title: | Rapid differentiation of MOGAD and MS after a single optic neuritis |
| Creators Name: | Pakeerathan, T., Havla, J., Schwake, C., Salmen, A., Ringelstein, M., Aktas, O., Weise, M., Gernert, J.A., Kornek, B., Bsteh, G., Pröbstel, A.K., Papadopoulou, A., Kulsvehagen, L., Ayroza Galvão Ribeiro Gomes, A.B., Cerdá-Fuertes, N., Oertel, F.C., Duchow, A.S., Paul, F., Stellmann, J.P., Stolowy, N., Hellwig, K., Schneider-Gold, C., Kümpfel, T., Gold, R., Albrecht, P. and Ayzenberg, I. |
| Abstract: | BACKGROUND: Optic neuritis (ON) is a common manifestation of multiple sclerosis (MS) and myelin-oligodendrocyte-glycoprotein IgG-associated disease (MOGAD). This study evaluated the applicability of optical coherence tomography (OCT) for differentiating between both diseases in two independent cohorts. METHODS: One hundred sixty two patients from seven sites underwent standard OCT and high-contrast visual acuity (HCVA) testing at least 6 months after first ON. Of these, 100 patients (32 MOGAD, 68 MS) comprised the primary investigational cohort, while 62 patients (31 MOGAD, 31 MS) formed a validation cohort. A composite score distinguishing between MOGAD and MS was developed using multivariate logistic regression. RESULTS: Bilateral simultaneous ON occurred more frequently in MOGAD compared to MS (46.9 vs. 11.8%, p < 0.001). OCT revealed more peripapillary retinal nerve fiber layer (pRNFL) atrophy in all segments in MOGAD compared to predominantly temporal pRNFL atrophy in MS (p < 0.001). HCVA was better preserved in MS (p = 0.007). pRNFL thickness in all except for temporal segments was suitable for differentiating MOGAD and MS. Simultaneous bilateral ON and critical atrophy in nasal (< 58.5 µm) and temporal superior (< 105.5 µm) segments were included into the composite score as three independent predictors for MOGAD. The composite score distinguished MOGAD from MS with 75% sensitivity and 90% specificity in the investigational cohort, and 68% sensitivity and 87% specificity in the validation cohort. CONCLUSION: Following a single ON-episode, MOGAD exhibits more pronounced global pRNFL atrophy and lower visual acuity after ON compared to MS. The introduced OCT-based composite score enabled differentiation between the two entities across both cohorts. |
| Keywords: | Optical Coherence Tomography, Optic Neuritis, Visual Evoked Potential, Myelin-Oligodendrocyte-Glycoprotein IgG, Myelin Oligodendrocyte Glycoprotein IgG-Associated Disease, Multiple Sclerosis |
| Source: | Journal of Neurology |
| ISSN: | 0340-5354 |
| Publisher: | Springer |
| Date: | 9 September 2024 |
| Official Publication: | https://doi.org/10.1007/s00415-024-12666-w |
| PubMed: | View item in PubMed |
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