Contributions
Abstract: 185
Type: Oral
Abstract Category: Clinical aspects of MS - 10 Neuro-ophthalmology
Introduction: Acute optic neuritis (ON) is the most common optic neuropathy among young adults and it is a common inaugural presentation of inflammatory immune-mediated diseases. Developments have occurred regarding autoantibodies in Neuroimunology. This raises the possibility of improving the physiopathological understanding and even future treatments. Besides this, there are feel data about seronegative ON.
We aimed to assess the visual outcome and its predictors in a cohort of inaugural ON according to the antibody profile: Anti-aquaporin-4 (AQ4 positive), Anti Myelin oligodendrocyte glycoprotein (MOG positive) and seronegative group from a specialty neuroimunology center.
Methods: Consecutive patients admitted at an university-based Neuroimunology Clinics from 2012 to 2017 were enrolled. Inclusion criteria: isolated inflamatory ON and investigation of autoantibodies AQ4-IgG and MOG-IgG by a cell-based immunoassay (CBA). Clinical records were assessed for: severity, recurrence, radiologic features and treatment applied. Descriptive and univariate analyses were performed by classical methods and a logistic regression was modeled for multivariate adjustment and searching for predictors of visual improvement.
Results: Forty-two patients were included, mean age of 42 (+/-13) years, 78% female, mean time of follow up 110 (+/-91) months. Ten patients (23%) were positive for AQ4, 14 (33%) for MOG and 18 (42%) were seronegative. There was no difference regarding to age, gender, clinical severity (worst visual acuity - VA), laterality or recurrence. Severe visual impairment (VA < 20/200) on last follow-up was less frequent among MOG patients (14%) than AQ4 (60%) and Seronegative (50%) groups (p=0.044). The serologic status was the only predictor of improvement of VA on the last follow up, measured by the change among the 3 categories: severe (< 20/200), moderate (20/50 to 20/200) and mild (>20/50) ON (p=0.029). After multivariate adjustment including clinical severity and recurrence, the probability of improvement was 79% (95%CI 76-81%) for the MOG group, 38% (95%CI 34-41%) for the Seronegative one and 25% (95%CI 18-32%) for AQ4 (p< 0.001).
Conclusion: MOG positive ON had the best prognosis for VA recovery. The seronegative group had an intermediate course when compared to AQ4. We postulate that MOG-IgG pathology - associated with reversible changes of myelin without complement activation or inflammatory cell infiltration - may result in a better VA outcome.
Disclosure:
- Dr Laís Maria Gomes de Brito Ventura, Milena Sales Pitombeira, Aline de Moura Brasil Matos, Ana Beatriz Ayroza Galvao Ribeiro Gomes, Renata Barbosa Paolilo, Luana M Oliveira de Paula Salles,Dr Pedro H B Torretta, Dr Davi J F Solla, Dr Frederico Castelo moura: nothing to disclose.
- Dr Dagoberto Callegaro received grants rellated to congress meetings and preceptorship from Genzyme, Roche and Biogen
- Dr Samira Luíza apóstolos Pereira: received grants rellated to congress meetings and preceptorship from Genzyme, Roche
-Dr Douglas K Sato: Research support from japan society for the promotion os science, CAPES/Brasil, Euroimmun Ag and TEVA. Speaker for Biogen, Novartis, Genzyme, TEVA, Merck_serono, Roche, Bayer abd advisory board for shire, Merk-Serono and Quest/Atheba Diagnostics
Abstract: 185
Type: Oral
Abstract Category: Clinical aspects of MS - 10 Neuro-ophthalmology
Introduction: Acute optic neuritis (ON) is the most common optic neuropathy among young adults and it is a common inaugural presentation of inflammatory immune-mediated diseases. Developments have occurred regarding autoantibodies in Neuroimunology. This raises the possibility of improving the physiopathological understanding and even future treatments. Besides this, there are feel data about seronegative ON.
We aimed to assess the visual outcome and its predictors in a cohort of inaugural ON according to the antibody profile: Anti-aquaporin-4 (AQ4 positive), Anti Myelin oligodendrocyte glycoprotein (MOG positive) and seronegative group from a specialty neuroimunology center.
Methods: Consecutive patients admitted at an university-based Neuroimunology Clinics from 2012 to 2017 were enrolled. Inclusion criteria: isolated inflamatory ON and investigation of autoantibodies AQ4-IgG and MOG-IgG by a cell-based immunoassay (CBA). Clinical records were assessed for: severity, recurrence, radiologic features and treatment applied. Descriptive and univariate analyses were performed by classical methods and a logistic regression was modeled for multivariate adjustment and searching for predictors of visual improvement.
Results: Forty-two patients were included, mean age of 42 (+/-13) years, 78% female, mean time of follow up 110 (+/-91) months. Ten patients (23%) were positive for AQ4, 14 (33%) for MOG and 18 (42%) were seronegative. There was no difference regarding to age, gender, clinical severity (worst visual acuity - VA), laterality or recurrence. Severe visual impairment (VA < 20/200) on last follow-up was less frequent among MOG patients (14%) than AQ4 (60%) and Seronegative (50%) groups (p=0.044). The serologic status was the only predictor of improvement of VA on the last follow up, measured by the change among the 3 categories: severe (< 20/200), moderate (20/50 to 20/200) and mild (>20/50) ON (p=0.029). After multivariate adjustment including clinical severity and recurrence, the probability of improvement was 79% (95%CI 76-81%) for the MOG group, 38% (95%CI 34-41%) for the Seronegative one and 25% (95%CI 18-32%) for AQ4 (p< 0.001).
Conclusion: MOG positive ON had the best prognosis for VA recovery. The seronegative group had an intermediate course when compared to AQ4. We postulate that MOG-IgG pathology - associated with reversible changes of myelin without complement activation or inflammatory cell infiltration - may result in a better VA outcome.
Disclosure:
- Dr Laís Maria Gomes de Brito Ventura, Milena Sales Pitombeira, Aline de Moura Brasil Matos, Ana Beatriz Ayroza Galvao Ribeiro Gomes, Renata Barbosa Paolilo, Luana M Oliveira de Paula Salles,Dr Pedro H B Torretta, Dr Davi J F Solla, Dr Frederico Castelo moura: nothing to disclose.
- Dr Dagoberto Callegaro received grants rellated to congress meetings and preceptorship from Genzyme, Roche and Biogen
- Dr Samira Luíza apóstolos Pereira: received grants rellated to congress meetings and preceptorship from Genzyme, Roche
-Dr Douglas K Sato: Research support from japan society for the promotion os science, CAPES/Brasil, Euroimmun Ag and TEVA. Speaker for Biogen, Novartis, Genzyme, TEVA, Merck_serono, Roche, Bayer abd advisory board for shire, Merk-Serono and Quest/Atheba Diagnostics