Radiological differentiation of optic neuritis with myelin oligodendrocyte glycoprotein antibodies, aquaporin-4 antibodies, and multiple sclerosis
Radiological differentiation of optic neuritis with myelin oligodendrocyte glycoprotein antibodies, aquaporin-4 antibodies, and multiple sclerosis
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DOI：
10.1177/1352458515593406
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发表时间：
2016-04-01
影响因子：
5.8
通讯作者：
Dale, Russell C.
中科院分区：
文献类型：
--
作者：
Ramanathan, Sudarshini;Prelog, Kristina;Dale, Russell C.
背景：认识视神经炎 (ON) 的病因会影响治疗决策和视力结果。目的：我们旨在定义首发脱髓鞘性 ON 的放射学特征。方法：我们对 50 名患有首发髓磷脂少突胶质细胞糖蛋白 (MOG) 抗体相关性 ON (MOG-ON；n=19)、水通道蛋白 4 (AQP4) 抗体相关性 ON 的患者进行盲法放射学评估（AQP4-ON；n=11）、多发性硬化（MS）相关性 ON（MS-ON；n=13）和未分类 ON（n=7）。结果：双侧受累在 MOG-ON 和 AQP4-ON 中比 MS-ON 更常见（84% vs. 82% vs. 23%），视神经乳头肿胀在 MOG-ON 中更常见（53% vs. 9% vs. 0%）， AQP4-ON 中交叉受累更常见（5% vs. 64% vs. 15%），双侧视束受累在 AQP4-ON 中更常见（0% vs. 45% vs. 0%）。 MOG-ON 中球后受累更常见，而 AQP4-ON 中颅内受累更常见。 MOG-ON 和 AQP4-ON 的损伤长度比 MS-ON 更长。两个预测因子的组合，即不存在磁共振成像脑部异常和较高的病变程度评分，显示出区分自身抗体相关 ON（MOG 或 AQP4）和 MS 的良好能力。 AQP4-ON 更常出现严重且持续的视力障碍。结论：MOG-ON 和 AQP4-ON 更常见为双侧和纵向广泛。 MOG-ON 倾向于涉及前视路，而 AQP4-ON 则涉及后视路。
Background: Recognizing the cause of optic neuritis (ON) affects treatment decisions and visual outcomes.Objective: We aimed to define radiological features of first-episode demyelinating ON.Methods: We performed blinded radiological assessment of 50 patients presenting with first-episode myelin oligodendrocyte glycoprotein (MOG) antibody-associated ON (MOG-ON; n=19), aquaporin-4 (AQP4) antibody-associated ON (AQP4-ON; n=11), multiple sclerosis (MS)-associated ON (MS-ON; n=13), and unclassified ON (n=7).Results: Bilateral involvement was more common in MOG-ON and AQP4-ON than MS-ON (84% vs. 82% vs. 23%), optic nerve head swelling was more common in MOG-ON (53% vs. 9% vs. 0%), chiasmal involvement was more common in AQP4-ON (5% vs. 64% vs. 15%), and bilateral optic tract involvement was more common in AQP4-ON (0% vs. 45% vs. 0%). Retrobulbar involvement was more common in MOG-ON, whereas intracranial involvement was more common in AQP4-ON. MOG-ON and AQP4-ON had longer lesion lengths than MS-ON. The combination of two predictors, the absence of magnetic resonance imaging brain abnormalities and a higher lesion extent score, showed a good ability to discriminate between an autoantibody-associated ON (MOG or AQP4) and MS. AQP4-ON more frequently had severe and sustained visual impairment.Conclusion: MOG-ON and AQP4-ON are more commonly bilateral and longitudinally extensive. MOG-ON tends to involve the anterior optic pathway, whereas AQP4-ON the posterior optic pathway.