Clinical characteristics and prognosis of myelin oligodendrocyte glycoprotein antibody-seropositive paediatric optic neuritis in China

Song, Honglu; Zhou, Huanfen; Yang, Mo; Tan, Shaoying; Wang, Junqing; Xu, Quangang; Liu, Hongjuan; Wei, Shihui

doi:10.1136/bjophthalmol-2018-312399

Cited by 35 publications

(42 citation statements)

References 34 publications

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“…We were able to identify four studies reporting OCT findings in pediatric ON, and OCT measures could be pooled for three studies ( 33 , 41 , 67 ). Similar to adults, pRNFL thickness did not differ between pediatric AQP4-ON and MOG-ON eyes (7.4 μm, 95% CI: −17.1 to 32.0 μm; Supplementary Figure 8 ).…”

Section: Resultsmentioning

confidence: 99%

“…Of these, 202 articles were selected and assessed for eligibility at the full-text level. After careful evaluation, 35 studies were included that met the inclusion criteria ( 8 , 29 , 30 , 33 , 36 , 39 , 41 , 45 , 47 , 48 , 51 – 54 , 57 , 59 , 63 , 65 , 66 , 68 , 69 , 71 , 72 , 74 – 85 ). The detailed flow chart is presented in Supplementary Figure 9 .…”

Section: Resultsmentioning

confidence: 99%

“…We were able to identify three studies reporting visual outcomes in pediatric ON associated with seropositivity for AQP4-IgG and MOG-IgG ( 33 , 41 , 63 ). Similar to adults, the risk of a poor visual outcome (VA ≤ 20/200) was higher for AQP4-ON compared to MOG-ON (RR: 20.11, 95% CI: 4.79 to 84.34), but the sample sizes of the studies were rather small ( Supplementary Figure 10 ).…”

Section: Resultsmentioning

confidence: 99%

“…In this meta-analysis, we also attempted to examine OCT findings and visual outcomes in pediatric ON associated with AQP4-IgG and MOG-IgG seropositivity. However, this population has not been studied extensively and a systematic review of the literature revealed only four studies, with small numbers of participants ( 33 , 41 , 63 , 67 ). OCT measures could be pooled for three of these, two of which included Asian children ( 33 , 41 ).…”

Section: Discussionmentioning

confidence: 99%

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AQP4-IgG and MOG-IgG Related Optic Neuritis—Prevalence, Optical Coherence Tomography Findings, and Visual Outcomes: A Systematic Review and Meta-Analysis

et al. 2020

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Background: Optic neuritis (ON) is a cardinal manifestation of multiple sclerosis (MS), aquaporin-4 (AQP4)-IgG-, and myelin oligodendrocyte glycoprotein (MOG)-IgG-associated disease. However, the prevalence of AQP4-IgG seropositivity and MOG-IgG seropositivity in isolated ON is unclear, and studies comparing visual outcomes and optical coherence tomography (OCT)-derived structural retinal measures between MS-ON, AQP4-ON, and MOG-ON eyes are limited by small sample sizes. Objectives: (1) To assess the prevalence of AQP4-IgG and MOG-IgG seropositivity among patients presenting with isolated ON; (2) to compare visual outcomes and OCT measures between AQP4-ON, MOG-ON, and MS-ON eyes. Methods: In this systematic review and meta-analysis, a total of 65 eligible studies were identified by PubMed search. Statistical analyses were performed with random effects models. Results: In adults with isolated ON, AQP4-IgG seroprevalence was 4% in non-Asian and 27% in Asian populations, whereas MOG-IgG seroprevalence was 8 and 20%, respectively. In children, AQP4-IgG seroprevalence was 0.4% in non-Asian and 15% in Asian populations, whereas MOG-IgG seroprevalence was 47 and 31%, respectively. AQP4-ON eyes had lower peri-papillary retinal nerve fiber layer (pRNFL; −11.7 μm, 95% CI: −15.2 to −8.3 μm) and macular ganglion cell + inner plexiform layer (GCIPL; −9.0 μm, 95% CI: −12.5 to −5.4 μm) thicknesses compared with MS-ON eyes. Similarly, pRNFL (−11.2 μm, 95% CI: −21.5 to −0.9 μm) and GCIPL (−6.1 μm, 95% CI: −10.8 to −1.3 μm) thicknesses were lower in MOG-ON compared to MS-ON eyes, but did not differ between AQP4-ON and MOG-ON eyes (pRNFL: −1.9 μm, 95% CI: −9.1 to 5.4 μm; GCIPL: −2.6 μm, 95% CI: −8.9 to 3.8 μm). Visual outcomes were worse in AQP4-ON compared to both MOG-ON (mean logMAR difference: 0.60, 95% CI: 0.39 to 0.81) and MS-ON eyes (mean logMAR difference: 0.68, 95% CI: 0.40 to 0.96) but were similar in MOG-ON and MS-ON eyes (mean logMAR difference: 0.04, 95% CI: −0.05 to 0.14). Conclusions: AQP4-IgG- and MOG-IgG-associated disease are important diagnostic considerations in adults presenting with isolated ON, especially in Asian populations. Furthermore, MOG-IgG seroprevalence is especially high in pediatric isolated ON, in both non-Asian and Asian populations. Despite a similar severity of GCIPL and pRNFL thinning in AQP4-ON and MOG-ON, AQP4-ON is associated with markedly worse visual outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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AQP4-IgG and MOG-IgG Related Optic Neuritis—Prevalence, Optical Coherence Tomography Findings, and Visual Outcomes: A Systematic Review and Meta-Analysis

et al. 2020

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“…The serum titer of MOG-IgG is associated with age, onset type, therapy in the acute phase, and disease activity and also predicts prognosis. 3,25,26 The negative transformation of antibody predicts good prognosis, 2 whereas high titers predict a recurrent disease course. 27 All possible confounders in our study were comparable between high and low MOG-IgG titer groups.…”

Section: Discussionmentioning

confidence: 99%

Long-term efficacy of mycophenolate mofetil in myelin oligodendrocyte glycoprotein antibody-associated disorders

Ren

et al. 2020

Neurol Neuroimmunol Neuroinflamm

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ObjectiveTo investigate whether the use of mycophenolate mofetil (MMF) could reduce the relapse risk in patients with myelin oligodendrocyte glycoprotein (MOG)-immunoglobulin G (IgG)-associated disorders (MOGADs).MethodsThis prospective observational cohort study included patients with MOGAD at Peking Union Medical College Hospital between January 1, 2017, and April 30, 2019. The patients were divided into 2 groups: those with (MMF+) or without (MMF−) MMF therapy. The primary outcome was relapse at follow-up. We used Cox proportional hazards models to calculate hazard ratios (HRs) for relapse.ResultsSeventy-nine patients were included in our MOG cohort. Fifty (63.3%) were adults at index date, and 47 (59.5%) were women. Fifty-four (68.4%) were in the MMF+ group, and 25 (31.6%) were in the MMF− group. Clinical and demographic factors, MOG-IgG titer, and follow-up time (median, 472.5 days for MMF+, 261.0 days for MMF−) were comparable between the groups. Relapse rates were 7.4% (4/54) in the MMF+ group and 44.0% (11/25) in the MMF− group. Of all potential confounders, only the use of MMF was associated with reduced risk of relapse. The HR for relapse among patients in the MMF+ group was 0.14 (95% CI, 0.05–0.45) and was 0.08 (95% CI, 0.02–0.28) in a model adjusted for age, sex, disease course, and MOG-IgG titer. MMF therapy also remained associated with a reduced relapse risk in sensitivity analyses. Only one patient (1.9%) discontinued MMF therapy because of adverse effect.ConclusionsThese findings provide a clinical evidence that MMF immunosuppression therapy may prevent relapse in patients with MOGAD.Classification of evidenceThis study provides class IV evidence that for patients with MOGAD, MMF reduces relapse risk.

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MOG-IgG Among Participants in the Pediatric Optic Neuritis Prospective Outcomes Study

et al. 2021

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Myelin oligodendrocyte glycoprotein (MOG) immunoglobulin G (IgG)-associated disorder (MOGAD) is a recently described entity that is distinct from multiple sclerosis (MS) and aquaporin-4 (AQP4)-IgG-positive neuromyelitis optica spectrum disorder. 1-3 A small cohort from the Pediatric Optic Neuritis Prospective Outcomes Study 4 underwent MOG-IgG testing and we compared those whose results were MOG-IgG positive with those whose results were negative.Methods | The study, protocol, and Health Insurance Portability and Accountability Act-compliant informed consent forms were approved by each site's institutional review board. Each patient's parent or guardian provided written informed consent. Children also provided written consent when applicable as determined by the local institutional review board. Parents of 13 of 44 study participants who underwent MOG-IgG testing also provided written consent to provide their child's serum to the

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Clinical characteristics and prognosis of myelin oligodendrocyte glycoprotein antibody-seropositive paediatric optic neuritis in China

Cited by 35 publications

References 34 publications

AQP4-IgG and MOG-IgG Related Optic Neuritis—Prevalence, Optical Coherence Tomography Findings, and Visual Outcomes: A Systematic Review and Meta-Analysis

AQP4-IgG and MOG-IgG Related Optic Neuritis—Prevalence, Optical Coherence Tomography Findings, and Visual Outcomes: A Systematic Review and Meta-Analysis

Long-term efficacy of mycophenolate mofetil in myelin oligodendrocyte glycoprotein antibody-associated disorders

MOG-IgG Among Participants in the Pediatric Optic Neuritis Prospective Outcomes Study

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