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@ARTICLE{Pakeerathan:283151,
author = {Pakeerathan, Thivya and Davis, James and Henderson, Amanda
D and Sotirchos, Elias S and Said, Yana and Havla, Joachim
and Ringelstein, Marius and Aktas, Orhan and Weise, Margit
and Gernert, Jonathan A and Kornek, Barbara and Bsteh,
Gabriel and Rommer, Paulus S and Krajnc, Nik and Pröbstel,
Anne-Katrin and Papadopoulou, Athina and Kulsvehagen, Laila
and Pretzsch, Roxanne and Schoenholzer, Kean and
Padungkiatsagul, Tanyatuth and Moss, Heather E and
Villarreal Navarro, Sylvia E and Herwerth, Marina and
Graure, Madalina and Kana, Veronika and Stiebel-Kalish,
Hadas and Zlatkin, Rita and Arnold, Anthony C and Bonelli,
Laura and Stellmann, Jan-Patrick and Stolowy, Natacha and
Schwake, Carolin and Schneider-Gold, Christiane and
Kümpfel, Tania and Albrecht, Philipp and Rattanathamsakul,
Natthapon and Pittock, Sean J and Flanagan, Eoin P and
Carta, Sara and Mariotto, Sara and Gold, Ralf and Chen, John
J and Ayzenberg, Ilya},
title = {{OCT}-{B}ased {D}ifferentiation of {F}irst {A}cute {O}ptic
{N}euritis: {A}n {I}nternational {S}tudy of 111 {P}atients
{W}ith {NMOSD} and {MOGAD}.},
journal = {Neurology: Neuroimmunology $\&$ Neuroinflammation ;
official journal of the American Academy of Neurology},
volume = {13},
number = {2},
issn = {2332-7812},
address = {Philadelphia, Pa.},
publisher = {Wolters Kluwer},
reportid = {DZNE-2026-00047},
pages = {e200531},
year = {2026},
abstract = {Severe optic neuritis (ON) is a common clinical
manifestation in myelin oligodendrocyte glycoprotein
antibody-associated disease (MOGAD) and neuromyelitis optica
spectrum disorder (NMOSD). Given distinct prognoses and
often the necessity of early plasma exchange in NMOSD,
prompt differentiation is crucial. In this study, we
investigated the utility of optical coherence tomography
(OCT) in differentiating between first acute NMOSD-ON and
MOGAD-associated optic neuritis (MOGAD-ON), as well as
specific factors associated with disc edema.In this
retrospective multicenter study, 111 adult patients with
MOGAD or aquaporin-4 antibody-positive NMOSD who experienced
a first ON and underwent OCT within 2 weeks of symptom onset
were included from 14 centers across 8 countries.
Peripapillary retinal nerve fiber layer (pRNFL) thickness in
µm was analyzed, including the average of both eyes in
cases of bilateral manifestation.Eighty-three patients with
MOGAD (51 women; 124 ON eyes; bilateral ON $48.2\%)$ and 28
with NMOSD (24 women; 36 ON eyes; bilateral ON $21.4\%)$
were enrolled. A significant increase in pRNFL thickness
(>2SD), suggestive of disc edema, was observed in $73.4\%$
of MOGAD-ON eyes and $11.1\%$ of NMOSD-ON eyes (p < 0.001).
The pRNFL thickness cutoff of 117.5 µm provided $92.9\%$
specificity and $71.1\%$ sensitivity in distinguishing
between MOGAD-ON and NMOSD-ON (area under the curve =
0.838). There was no association between pRNFL thickening
and MOG-IgG titer (high vs low), body mass index, or the
delay between ON onset and OCT. Simultaneous bilateral
MOGAD-ON was associated with significantly more pronounced
pRNFL thickening.Acute-stage OCT contributes to the rapid
and accurate differentiation between MOGAD-ON and NMOSD-ON
prior to antibody confirmation, which can be critical for
timely therapeutic decisions.},
keywords = {Humans / Tomography, Optical Coherence: methods / Female /
Optic Neuritis: diagnostic imaging / Optic Neuritis:
diagnosis / Male / Adult / Neuromyelitis Optica: diagnosis /
Neuromyelitis Optica: diagnostic imaging / Middle Aged /
Retrospective Studies / Diagnosis, Differential /
Myelin-Oligodendrocyte Glycoprotein: immunology / Young
Adult / Aquaporin 4: immunology / Aged / Autoantibodies /
Myelin Oligodendrocyte Glycoprotein Antibody-Associated
Disease / Myelin-Oligodendrocyte Glycoprotein (NLM
Chemicals) / Aquaporin 4 (NLM Chemicals) / Autoantibodies
(NLM Chemicals)},
cin = {AG Pröbstel},
ddc = {610},
cid = {I:(DE-2719)1013045},
pnm = {353 - Clinical and Health Care Research (POF4-353)},
pid = {G:(DE-HGF)POF4-353},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:41499724},
doi = {10.1212/NXI.0000000000200531},
url = {https://pub.dzne.de/record/283151},
}