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Related Experiment Video

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Retinal ganglion cell function in AQP4+ and MOG+ optic neuritis.

Katharina Messias1, Renata Moreto2, Kelvin Ferrari Corniani2

  • 1Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil; Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.

Multiple Sclerosis and Related Disorders
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Summary

Anti-aquaporin-4 antibody (AQP4+) optic neuritis (ON) causes more severe visual and functional impairment than myelin oligodendrocyte glycoprotein (MOG+) ON. AQP4+ ON shows correlated structural loss, while MOG+ ON suggests compensatory mechanisms.

Keywords:
Full-field electroretinogramGanglion cell functionMyelin oligodendrocyte glycoprotein (MOG)-IgG associated disease (MOGAD)Neuromyelitis optica spectrum disorder (NMOSD)Optic neuritis (ON)Optical coherence tomography (OCT)

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Area of Science:

  • Neuro-ophthalmology
  • Immunology of the nervous system
  • Retinal imaging and electrophysiology

Background:

  • Optic neuritis (ON) can be associated with antibodies against aquaporin-4 (AQP4+) or myelin oligodendrocyte glycoprotein (MOG+).
  • Differentiating AQP4+ ON and MOG+ ON is crucial for prognosis and treatment.
  • Retinal ganglion cell function and structure are key indicators of visual pathway integrity.

Purpose of the Study:

  • To compare retinal ganglion cell function and structure in patients with AQP4+ ON versus MOG+ ON.
  • To investigate the relationship between visual function, retinal structure, and antibody status in ON.

Main Methods:

  • Included patients with a history of ON and positive serological tests for AQP4 or MOG.
  • Performed ophthalmological examinations, best corrected visual acuity (BCVA), visual field tests (mean deviation, MD), and spectral-domain optical coherence tomography (OCT).
  • Recorded full-field electroretinography (ERG) including photopic negative response (PhNR) to assess retinal ganglion cell function.

Main Results:

  • AQP4+ ON eyes had significantly worse BCVA and thinner inner retinal layers (mGCL) compared to MOG+ ON eyes.
  • PhNR amplitude was significantly reduced in AQP4+ ON eyes compared to both controls and MOG+ ON eyes.
  • In AQP4+ ON, PhNR amplitude correlated with visual field MD and GCL thickness, indicating functional-structural relationships.

Conclusions:

  • Visual and functional impairment is more severe in AQP4+ ON and correlates with structural damage.
  • MOG+ ON eyes exhibit a dissociation between structure and function, possibly due to post-retinal or central compensatory mechanisms.
  • These findings highlight distinct pathophysiological pathways and clinical outcomes in AQP4+ and MOG+ ON.