Pattern Visually Evoked Potentials in Japanese Girl With Optic Neuritis and Seropositive to Anti-myelin Oligodendrocyte Glycoprotein (MOG) Antibody

Abstract

Purpose: To describe a Japanese girl with unilateral optic neuritis who was seropositive for the anti-myelin-oligodendrocyte glycoprotein (MOG). Serial recordings of the pattern visual evoked potentials (pVEPs) were made to follow the dynamic changes of the disease activity. Observations: A 5-year-old girl developed a sudden reduction of vision and deep ocular pain in her right eye. On examination at our university hospital, the best-corrected visual acuity (BCVA) was light perception, and a swelling of the optic disc and tortuous vessels at the posterior pole of the right eye were observed. MRI demonstrated that her right optic nerve was hyperintense on short TI inversion recovery (STIR) sequence. A diagnosis of right papillitis was made, and she was treated with steroid pulse therapy followed by a gradual tapering of oral prednisolone. The visual acuity decreased to no light perception and plasmapheresis combined with high-dose intravenous immunoglobulin therapy was performed. The decimal visual acuity rapidly improved and recovered to 1.2, and no recurrence was observed for at least 1 year. On day 19, she was found to be anti-MOG antibody positive and anti-Aquaporin 4 antibody negative. pVEPs were recorded during the course of the disease process which showed the dynamic changes of the physiology of the visual pathways. The implicit times of the N75 and P100 components were prolonged in the right eye in the acute phase. The right visual acuity remained at 1.2 for at least 1 year, but the implicit times of the N75 and P100 components of the pVEPs of the right eye were still prolonged compared to left eye. Conclusion: Our findings indicate a positive relationship between the anti-MOG antibodies-positivity and the prolonged pVEPs. Further analyses of the pVEPs and other clinical findings of the optic neuritis are needed to establish the clinical significance of the anti-MOG antibodies positivity and optic neuritis for the diagnosis, treatment, and prognosis for this disease.

Myelin oligodendrocyte glycoprotein (MOG)-IgG associated optic neuritis as a new issue in the differential diagnosis of optic neuropathy

“…The studies indicate that P100 latency is more delayed in MS than NMOSD, with a greater proportion of absent responses and less frequent subclinical alterations in the latter group [22]. Prolongation of P100 latency persists after the acute phase, even when visual acuity returns to normal [23]. The characteristics of MOG-IgG positive ON in comparison to AQP4-IgG positive ON and MS-related ON are presented in Table I.…”

Treatment of MOG-IgG associated disease in paediatric patients: A systematic review

“…IVIG was used to treat acute relapses in at least 21% (128/621) of the patients in the following doses/regimens: 1-2 g/kg in 2-5 days or 400 mg/kg/day in 5 days. A single study (Takano et al, 2019) reported the use of IVIG160 mg/kg in a single dose (2.5 g). Thirty-three percent (20/61) of the studies described the use of plasma exchange (PLEX), 3 to 7 cycles, in 4% (26/621) of the patients.…”