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Myelin oligodendrocyte glycoprotein-IgG-associated optic neuritis

Chun, Bo Younga,b; Cestari, Dean M.c

Current Opinion in Ophthalmology: November 2018 - Volume 29 - Issue 6 - p 508–513
doi: 10.1097/ICU.0000000000000520
NEURO-OPHTHALMOLOGY: Edited by Dean M. Cestari
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Purpose of review Myelin oligodendrocyte glycoprotein (MOG)-IgG-associated optic neuritis has been established as a new entity of optic neuropathy. We will review recent advances in pathophysiology, diagnosis, and clinical manifestations of MOG-IgG-associated optic neuritis to better understand its distinctive characteristics.

Recent findings MOG is expressed on the surface of myelin sheaths and oligodendrocytes. MOG is highly immunogenic and is a potential target of inflammatory demyelinating disease. MOG-IgG activate immune responses and cause demyelination without astrocytopathy. MOG-IgG are measured by cell-based assays, which have higher sensitivity and specificity than ELISA. Patients with MOG-IgG-associated optic neuritis present with initially severe vision loss, are more likely to have optic disc edema, but have favorable visual outcomes. Furthermore, patients with MOG-IgG-associated optic neuritis have higher rates of recurrence compared with MOG-IgG seronegative patients. MOG-IgG-associated optic neuritis responds well to steroid treatment, however, close monitoring for signs of relapse and long-term immunosuppression may be necessary.

Summary MOG-IgG associated optic neuritis demonstrates distinctive pathophysiological and clinical characteristics from optic neuritis in aquaporin4-IgG seropositive or multiple sclerosis patients. Measurements of MOG-IgG titers by cell-based assays will be helpful for the diagnosis and treatment of optic neuritis.

aDepartment of Ophthalmology

bBrain Science & Engineering Institute, School of Medicine, Kyungpook National University, Daegu, South Korea

cNeuro-Ophthalmology Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA

Correspondence to Bo Young Chun, MD, PhD, Associate professor, Department of Ophthalmology, Brain Science & Engineering Institute, School of Medicine, Kyungpook National University, 680 Gukchaebosang Street, Jung-gu, Daegu 700-422, South Korea. Tel: +82 53 420 5818; fax: +82 53 426 6552; e-mail: byjun424@hotmail.com

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