Age-dependent favorable visual recovery despite significant retinal atrophy in pediatric MOGAD : how much retina do you really need to see well?
Havla, Joachim (Ludwig-Maximilians-Universität München)
Pakeerathan, Thivya (Ruhr-University Bochum)
Schwake, Carolin (Ruhr-University Bochum)
Bennett, Jeffrey L. (University of Colorado Anschutz Medical Campu)
Kleiter, Ingo (Marianne-Strauß-Klinik)
Felipe-Rucián, Ana (Hospital Universitari Vall d'Hebron)
Joachim, Stephanie C. (Ruhr-University Bochum)
Lotz-Havla, Amelie S. (Ludwig-Maximilians-Universität München)
Kümpfel, Tania (Ludwig-Maximilians-Universität München)
Krumbholz, Markus (University Hospital of Tübingen (Alemanya))
Wendel, Eva M. (Olgaspital Stuttgart)
Reindl, Markus (Medical University of Innsbruck)
Thiels, Charlotte (Ruhr-University)
Lücke, Thomas (Ruhr-University)
Hellwig, Kerstin (Ruhr-University Bochum)
Gold, Ralf (Ruhr-University Bochum)
Rostasy, Kevin (University Witten/Herdecke)
Ayzenberg, Ilya (Sechenov First Moscow State Medical University)
Universitat Autònoma de Barcelona

Data:	2021
Resum:	To investigate age-related severity, patterns of retinal structural damage, and functional visual recovery in pediatric and adult cohorts of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) optic neuritis (ON). All MOGAD patients from the 5 participating centers were included. Patients with initial manifestation <18 years were included in the pediatric (MOGAD ped) cohort and patients with ≥18 years in the adult (MOGAD adult) cohort. For patients with MOGAD ON, examinations at least ≥6 months after ON onset were included in the analyses. Using spectral domain optical coherence tomography (SD-OCT), we acquired peripapillary retinal nerve fiber layer thickness (pRNFL) and volumes of combined ganglion cell and inner plexiform layer (GCIPL). High- and 2. 5% low-contrast visual acuity (HCVA, LCVA) and visual-evoked potentials (VEP) were obtained. Twenty MOGAD ped (10. 3±3. 7 years, 30 MOGAD ON eyes) and 39 MOGAD adult (34. 9±11. 6 years, 42 MOGAD ON eyes) patients were included. The average number of ON episodes per ON eye was similar in both groups (1. 8±1. 3 and 2. 0±1. 7). In both pediatric and adult MOGAD, ON led to pronounced neuroaxonal retinal atrophy (pRNFL: 63. 1±18. 7 and 64. 3±22. 9 μm; GCIPL: 0. 42±0. 09 and 0. 44±0. 13 mm 3, respectively) and moderate delay of the VEP latencies (117. 9±10. 7 and 118. 0±14. 5 ms). In contrast, visual acuity was substantially better in children (HCVA: 51. 4±9. 3 vs. 35. 0±20. 6 raw letters, p =0. 001; LCVA: 22. 8±14. 6 vs. 13. 5±16. 4, p =0. 028). Complete visual recovery (HCVA-logMAR 0. 0) occurred in 73. 3% of MOGAD ped and 31% MOGAD adults ON eyes, while 3. 3% and 31% demonstrated moderate to severe (logMAR > 0. 5) visual impairment. Independent of retinal atrophy, age at ON onset significantly correlated with visual outcome. Pediatric MOGAD ON showed better visual recovery than adult MOGAD ON despite profound and almost identical neuroaxonal retinal atrophy. Age-related cortical neuroplasticity may account for the substantial discrepancy between structural changes and functional outcomes. The online version contains supplementary material available at 10. 1186/s12974-021-02160-9.
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 ; Optic neuritis ; Myelin oligodendrocyte glycoprotein IgG ; MOGAD
Publicat a:	Journal of neuroinflammation, Vol. 18 (may 2021) , ISSN 1742-2094

DOI: 10.1186/s12974-021-02160-9
PMID: 34051804

10 p, 1.7 MB

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