Characteristic retinal atrophy pattern allows differentiation between pediatric MOGAD and MS after a single optic neuritis episode
Pakeerathan, T. (Ruhr-University Bochum)
Havla, Joachim (Ludwig-Maximilians-Universität München)
Schwake, C. (Ruhr-University Bochum)
Salmen, A. (University of Bern. Department of Neurology, Inselspital, Bern University Hospital)
Bigi, S. (University of Bern)
Abegg, M. (University of Bern)
Brügger, D. (University of Bern)
Ferrazzini, T. (University of Bern)
Runge, A.-K. (University of Bern)
Breu, Markus (Medical University of Vienna)
Kornek, B. (Medical University of Vienna)
Bsteh, G. (Medical University of Vienna)
Felipe-Rucián, Ana (Hospital Universitari Vall d'Hebron)
Ringelstein, M. (Heinrich-Heine-University Düsseldorf)
Aktas, Orhan (Heinrich-Heine-University Düsseldorf)
Karenfort, M. (Heinrich-Heine-University Düsseldorf)
Wendel, E. (Olgahospital)
Kleiter, I. (Marianne-Strauß-Klinik)
Hellwig, K. (Ruhr-University Bochum. Department of Neurology, St. Josef-Hospital)
Kümpfel, Tania (Ludwig-Maximilians-Universität München)
Thiels, C. (Ruhr-University)
Lücke, T. (Ruhr-University)
Gold, R. (Ruhr-University Bochum)
Rostasy, K. (University Witten/Herdecke)
Ayzenberg, I. (Ruhr-University Bochum)
Universitat Autònoma de Barcelona

Data:	2022
Resum:	Optic neuritis (ON) is the most prevalent manifestation of pediatric multiple sclerosis (MS ped) and myelin-oligodendrocyte glycoprotein antibody-associated disease (MOGAD ped) in children > 6 years. In this study, we investigated retinal atrophy patterns and diagnostic accuracy of optical coherence tomography (OCT) in differentiating between both diseases after the first ON episode. Patients were retrospectively identified in eight tertial referral centers. OCT, VEP and high/low-contrast visual acuity (HCVA/LCVA) have been investigated > 6 months after the first ON. Prevalence of pathological OCT findings was identified based on data of 144 age-matched healthy controls. Thirteen MOGAD ped (10. 7 ± 4. 2 years, F:M 8:5, 21 ON eyes) and 21 MS ped (14. 3 ± 2. 4 years, F:M 19:2, 24 ON eyes) patients were recruited. We observed a significantly more profound atrophy of both peripapillary and macular retinal nerve fiber layer in MOGAD ped compared to MS ped (pRNFL global: 68. 2 ± 16. 9 vs. 89. 4 ± 12. 3 µm, p < 0. 001; mRNFL: 0. 12 ± 0. 01 vs. 0. 14 ± 0. 01 mm 3, p < 0. 001). Neither other macular layers nor P100 latency differed. MOGAD ped developed global atrophy affecting all peripapillary segments, while MS ped displayed predominantly temporal thinning. Nasal pRNFL allowed differentiation between both diseases with the highest diagnostic accuracy (AUC = 0. 902, cutoff < 62. 5 µm, 90. 5% sensitivity and 70. 8% specificity for MOGAD ped). OCT was also substantially more sensitive compared to VEP in identification of ON eyes in MOGAD (pathological findings in 90% vs. 14%, p = 0. 016). First MOGAD-ON results in a more severe global peripapillary atrophy compared to predominantly temporal thinning in MS-ON. Nasal pRNFL allows differentiation between both diseases with the highest accuracy, supporting the additional diagnostic value of OCT in children with ON.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Optical coherence tomography ; Visual evoked potential ; Optic neuritis ; Myelin-oligodendrocyte-glycoprotein IgG ; MOGAD ; Multiple sclerosis ; Pediatric patients ; Children
Publicat a:	Journal of Neurology, Vol. 269 (july 2022) , p. 6366-6376, ISSN 1432-1459

DOI: 10.1007/s00415-022-11256-y
PMID: 35869995

11 p, 1.1 MB

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