The use of OCT in good visual acuity MOGAD and AQP4-NMOSD patients; with and without optic neuritis

A Roca-Fernández; V Camera; G Loncarevic-Whitaker; S Messina; R Mariano; A Vincent; S Sharma; M I Leite; J Palace

doi:10.1177/20552173211066446

The use of OCT in good visual acuity MOGAD and AQP4-NMOSD patients; with and without optic neuritis

Mult Scler J Exp Transl Clin. 2021 Dec 22;7(4):20552173211066446. doi: 10.1177/20552173211066446. eCollection 2021 Oct.

Authors

A Roca-Fernández¹, V Camera¹, G Loncarevic-Whitaker², S Messina¹, R Mariano¹, A Vincent¹, S Sharma³, M I Leite¹, J Palace¹

Affiliations

¹ Nuffield Department of Clinical Neuroscience, University Of Oxford, UK.
² University of Oxford Clinical Medical School, Medical Science Division, University of Oxford, UK.
³ Department of Ophthalmology, Oxford University Hospitals, National Health Service Trust, Oxford, UK.

Abstract

Myelin oligodendrocyte-antibody-associated disease (MOGAD) often presents with severe optic neuritis (ON) but tends to recover better than in aquaporin-4 antibody neuromyelitis optica spectrum disorder (AQP4-NMOSD). We measured OCT and VEP in MOGAD and AQP4-NMOSD eyes with good visual function, with or without previous ON episodes. Surprisingly, OCT and/or VEPs were abnormal in 84% MOGAD-ON versus 38% AQP4-NMOSD-ON eyes (p = 0.009) with good vision, compared with 18% and 17% respectively of eyes with no previous ON. A sub-group with macular OCT performed as part of a research study confirmed both retinal and macular defects in visually-recovered MOGAD eyes. These findings have implications for investigation and management of MOGAD patients.

Keywords: Neuromyelitis Optica spectrum disorder (NMOSD); Optic Neuritis; Visual function; myelin oligodendrocyte glycoprotein antibody disease (MOGAD) opticcoherence tomography (OCT); visual evoked potentials (VEP).

Grants and funding

MR/T024682/1/MRC_/Medical Research Council/United Kingdom