Abstract
Purpose :
Myelin oligodendrocyte glycoprotein related optic neuritis (MOG-ON) attacks are associated with good visual outcome in most cases if treatment is initiated in a timely manner. However, poor visual outcomes have been described in up to 15-20% of patients. Little is known about the factors contributing to poor visual outcome. This study sought to identify predictors of worse visual outcomes in patients with MOG-ON.
Methods :
We performed a retrospective chart review of all patients (N=46) from two tertiary center neuro-ophthalmology practices in Toronto, Ontario, with a diagnosis of MOG-ON confirmed by enhanced MRI orbits with fat saturated sequences and positive antibody titers obtained through cell-based assay. Clinical, laboratory, and neuro-radiological data was collected. Poor visual outcome was defined as final central visual acuity (VA) of less than 0.4 (logMAR) or mean deviation (MD) on formal perimetry as less than -5.0 dB in the affected eye.
Results :
Data from 66 eyes was analyzed. Mean follow-up period was 26.4 months. Average VA on presentation was 0.93 +/- 0.12, and 0.23 +/- 0.072 (p<0.001) at last visit. Average MD on presentation was -18.05 +/- 1.41, and -7.67 +/- 1.17 (p<0.001) at last visit. Twenty patients (43%) had poor visual outcome as defined in methods. The average time from symptoms onset to initiation of treatment was 17.4 days, and those who had poor outcomes averaged 32.9 days before receiving treatment, compared to the rest who averaged 6.3 days (p=0.02). Out of 20 patients with poor visual outcome, 7 (35%) had a relapsing course, whereas only 4/26 patients (15%) who had good visual outcome had a relapse (p=0.06). The average presenting RNFL thickness between good and poor visual outcome groups was not significant (p = 0.21)
Conclusions :
Poor visual outcomes in patients with MOG-ON are associated with longer time to treatment initiation emphasizing importance of timely diagnosis and treatment in MOG-ON.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.