Abstract Details

Title Pediatric Myelin-oligodendrocyte Glycoprotein Associated Demyelinating Optic Neuritis: Clinical Characteristics and Outcomes

Topic Neuro-ophthalmology/Neuro-otology

Presentation(s) S40 - Neuro-ophthalmology/Neuro-otology (1:36 PM-1:48 PM)

Poster/Presentation
Number 004

Background Myelin oligodendrocyte glycoprotein associated diseases (MOGAD) commonly presents with optic neuritis (ON), transverse myelitis (TM), isolated cerebellar involvement, isolated cortical encephalitis, ADEM (acute disseminated encephalomyelitis). The clinical and visual outcomes in patients with childhood MOGAD presenting with ON have not been well studied

Objective to assess the clinical characteristics, outcomes and utility of Ocular coherence tomography to predict outcomes in pediatric Myelin oligodendrocyte glycoprotein associated optic neuritis patients.

Design/Methods

We conducted a multicenter retrospective study in a cohort of pediatric patients (age <18) with seropositive MOGAD. Patient’s demographics and clinical management information were extracted from electronic medical record system. Retinal nerve fiber layer (RNFL) thickness and median deviation (MD) were collected via neuro-ophthalmic testing.

Results

Eighteen patients were included in the study with a median age of onset 10 years (6-14), 12/18 were female, 6/18 were male, 13/18 (72%) presented with isolated ON as the first event, remaining five patients had ON as a part of combined demyelinating phenotype at the first event. Median follow-up was 31 months (5-41). 3/18 (17%) had recurrent ON alone, 3/18 (17%) relapsed with other phenotypes (TM, cerebellar attack, encephalitis, ADEM); six patients (28%) had bilateral optic nerve involvement during initial attack. Mean LogMAR visual acuity was 1.7 at onset in 24 affected eyes. Maximum visual recovery to LogMAR 0 is attained in 1 month (1-1.5) in 16 eyes. Median RNFL thickness within two weeks of ON onset is 180 microns (IQR: 146-250) in seven eyes without correlation to log MAR outcomes at two weeks with median 0.6 (IQR:0.2 to 2, P=0.16) or at two months with median 0 (IQR: 0-0.1, P=0.2)

Conclusions

Pediatric patients with MOGAD related optic neuritis often return to baseline visual acuity.

Authors/Disclosures
Naga Pradyumna Kothapalli, MD (Stanford University) PRESENTER	Dr. Kothapalli has nothing to disclose.
Ketaki Panse (UC Davis)	No disclosure on file
Akash Virupakshaiah, MD (UCSF)	Dr. Virupakshaiah has nothing to disclose.
Shannon M. Beres, MD (Stanford Children's Health/Lucille Packard Children's Hospital)	Dr. Beres has nothing to disclose.
Yin A. Liu, MD (UC Davis)	Dr. Liu has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Myrobalan. Dr. Liu has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Argenx.