Neuronal Afferent Visual System Damage in MOG-Antibody Associated Optic Neuritis Is as Severe as in AQP4-Antibody Positive NMOSD (P4.275)

Objective: To describe patterns of optic neuritis (ON) induced retinal damage in patients with antibodies to myelin oligodendrocyte glycoprotein (MOG-ab+) in comparison to patients with antibodies against aquaporin-4 (AQP4-ab+). Background: Recurrent ON has been reported in neuromyelitis optica spectrum disorder (NMOSD) patients with AQP4-ab and recently also in patients with MOG-ab. Methods: Retrospective analysis of afferent visual system damage in eleven patients in comparison to eleven AQP4-ab+ patients with ON and eleven healthy controls, both matched for age and gender. All subjects underwent optical coherence tomography examination of the retina. Results: Five MOG-ab+ patients had a previous AQP4-ab negative NMOSD diagnosis with ON and myelitis and six MOG-ab+ patients were previously diagnosed with recurrent ON or chronic relapsing inflammatory optic neuropathy. All patients were female, mean age was 42±18 years. Severely reduced retinal nerve fiber layer thickness and ganglion cell and inner plexiform layer volume was found in ON eyes of both MOG-ab+ (53±20 µm; 1.38±0.28 mm³) and AQP4-ab+ (60±22 µm; 1.41±0.27 mm³) patients compared to healthy controls (99±5 µm; 1.96±0.11 mm³). There was no significant difference in retinal measurements between MOG-ab+ and AQP4-ab+ Conclusions: MOG-Ab+ patients have severe retinal damage in the range of AQP4-ab+ NMOSD patients. This is in contrast to earlier studies, which reported less retinal neuronal loss in patients. Monitoring treatment efficacy will be crucial in limiting axonal damage in these patients. Disclosure: Dr. Zimmermann has received personal compensation for activities with Bayer and Teva as a speaker. Dr. Pache has nothing to disclose. Dr. Mikolajczak has received personal compensation for activities with Teva CNS as a speaker. Dr. Schumacher has nothing to disclose. Dr. Lacheta has nothing to disclose. Dr. Jarius has received research support from Merck Serono and the Dietmar Hopp Foundation to the Department of Neurology at the University of Heidelberg, Germany. Dr. Wildemann has received personal compensation for activities with Biogen Idec, Merck Serono, Teva Neuroscience, and Genzyme Corporation. Dr. Reindl has nothing to disclose. Dr. Waldman has received royalty payments from UpToDate. Dr. Ruprecht has received personal compensation for activities with Bayer Healthcare, Biogen Idec, Merck Serono, Sanofi/Genzyme, Teva, Roche, and Novartis. Dr. Asgari has nothing to disclose. Dr. Soelberg has nothing to disclose. Dr. Ringelstein has received personal compensation for activities with Novartis, Bayer Schering, Biogen Idec, and Genzyme. Dr. Aktas has received personal compensation for activities with Bayer, Biogen, Chugai, Genzyme, Novartis, Roche, Teva, Medimmune as an advisor/honoraria. Dr. Paul has received personal compensation for activities with Teva Neuroscience, Sanofi-Aventis Pharmaceuticals, Inc., Bayer Schering Pharma, Merck Serono, Biogen Idec, Medimmune, and Novartis. Dr. Brandt has received personal compensation for activities with Meedical (Medical GmbH Medizintechnik) as cofounder and director. Dr. Brandt has received personal compensation for activities with Heidelberg Engineering as a speaker. Dr. Brandt has recei