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Diagnostic Value of Inter-Eye Difference Metrics on OCT for Myelin Oligodendrocyte Glycoprotein Antibody-Associated
Giulio Volpe1, Neringa Jurkute1, Gabriela Girafa1
1From the Moorfields Eye Hospital NHS Foundation Trust (G.V., N.J., G.G.), London, United Kingdom; Department of Ophthalmology (G.V.), Institute of Clinical Neurosciences of Southern Switzerland (INSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland; Department of Neuro-ophthalmology (N.J.), The National Hospital for Neurology and Neurosurgery, UCL Queen Square Institute of Neurology, The National Hospital for Neurology and Neurosurgery; Institute of Ophthalmology (N.J.), University College London, United Kingdom; Federal University of the State of Rio de Janeiro (UNIRIO) (G.G.), Brazil; Einstein Center for Digital Future Berlin (H.G.Z.); Experimental and Clinical Research Center (ECRC) (H.G.Z., S.M., C.B., A.U.B., F.P., F.C.O.), Max-Delbrueck-Center Berlin & Charité - Universitätsmedizin Berlin; Neuroscience Clinical Research Center (NCRC) (H.G.Z., S.M., C.B., A.U.B., F.P., F.C.O.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Centre for Advanced Neurological Research (L.P., A.D.C.), Nitte University, Mangalore, India; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Divisions of Molecular Medicine and Infectious Diseases (M.R.Y.), Department of Medicine; Lundquist Institute for Biomedical Innovation at Harbor-University of California Los Angeles Medical Center (M.R.Y.), Torrance, CA; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; Department of Pediatrics (L.J.C.), University of Utah; Department of Neurology (F.P., F.C.O.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; National Hospital for Neurology and Neurosurgery (A.P.), University College London Hospitals NHS Foundation Trust, Moorfields Eye Hospital NHS Foundation Trust and Queen Square Dept. of Neuroinflammation, UCL, Queen Square Institute of Neurology, University College London, United Kingdom; and Neuro-ophthalmology Expert Centre (A.P.), Amsterdam University Medical Center, The Netherlands.
Background And Objectives:
The 2022 International Consortium for Optic Neuritis diagnostic criteria for optic neuritis (ON) include optical coherence tomography (OCT). The diagnostic value of intereye difference (IED) metrics is high for ON in patients with multiple sclerosis and aquaporin-4 antibody seropositive neuromyelitis optica spectrum disorders, but unknown in myelin oligodendrocyte glycoprotein antibody-associated ON (MOG-ON).
Methods:
A multicenter validation study was conducted on the published IED cutoff values (>4% or >4 μm in the macular ganglion cell and inner plexiform layer [mGCIP] or >5% or >5 μm in the peripapillary retinal nerve fiber layer [pRNFL]) in individuals with MOG-ON and age-matched and sex-matched healthy controls (HCs). Structural data were acquired with Spectralis spectral-domain OCT >6 months after ON. We calculated sensitivity, specificity, and receiver operating characteristics for both intereye percentage (IEPD) and absolute difference (IEAD).
Results:
A total of 66 individuals were included (MOG-ON N = 33; HCs N = 33). ON was unilateral in 20 and bilateral in 13 subjects. In the pooled analysis, the mGCIP IEPD was most sensitive (92%), followed by the mGCIP IEAD (88%) and pRNFL (84%). The same pattern was found for the specificity (mGCIP IEPD 82%, IEAD 82%; pRNFL IEPD 82%, IEAD 79%).In subgroup analyses, the diagnostic sensitivity was higher in subjects with unilateral ON (>99% for all metrics) compared with bilateral ON (61%-78%).
Discussion:
In individuals with MOG-ON, the diagnostic accuracy of OCT-based IED metrics for ON was high, especially of mGCIP IEPD.
Classification Of Evidence:
This study provides Class III evidence that the intereye difference on OCT can distinguish between those with MOG and normal controls.

