Optic neuritis in the era of biomarkers

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

The Optic Neuritis Treatment Trial, a landmark study completed in 1991, stratified the risk of multiple sclerosis in patients with optic neuritis. Since that time, unique biomarkers for optic neuritis have been found. The antibody against aquaporin-4 (AQP4)-immunoglobulin G (IgG) discovered in 2004 was found to be both the pathologic cause and a reliable biomarker for neuromyelitis optica spectrum disorders. This finding enabled an expanded definition of the phenotype of neuromyelitis optica spectrum disorder and improved treatment of the disease. Subsequently, myelin oligodendrocyte glycoprotein (MOG) IgG was recognized to be a marker for MOG-IgG-associated disorder, a central demyelinating disease characterized by recurrent optic neuritis, prominent disk edema, and perineural optic nerve enhancement on magnetic resonance imaging. Most multiple sclerosis disease-modifying agents are ineffective for AQP4-IgG-positive neuromyelitis optica spectrum disorder and MOG-IgG-associated disorder. Because there are crucial differences in treatment and prognosis between multiple sclerosis, AQP4-IgG-positive neuromyelitis optica spectrum disorder, and MOG-IgG-associated disorder, ophthalmologists should be aware of these new biomarkers of optic neuritis and incorporate their testing in all patients with atypical optic neuritis.

Original languageEnglish (US)
JournalSurvey of ophthalmology
DOIs
StateAccepted/In press - Jan 1 2019

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Optic Neuritis
Myelin-Oligodendrocyte Glycoprotein
Neuromyelitis Optica
Immunoglobulin G
Biomarkers
Aquaporin 4
Multiple Sclerosis
Demyelinating Diseases
Optic Nerve
Edema
Therapeutics
Magnetic Resonance Imaging
Phenotype
Antibodies

Keywords

  • aquaporin-4 antibodies (AQP4-IgG)
  • multiple sclerosis
  • myelin oligodendrocyte glycoprotein antibodies (MOG-IgG)
  • neuromyelitis optica spectrum disorder (NMOSD)
  • optic neuritis

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Optic neuritis in the era of biomarkers. / Chen, John; Pittock, Sean J; Flanagan, Eoin; Lennon, Vanda A; Bhatti, M. Tariq.

In: Survey of ophthalmology, 01.01.2019.

Research output: Contribution to journalReview article

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abstract = "The Optic Neuritis Treatment Trial, a landmark study completed in 1991, stratified the risk of multiple sclerosis in patients with optic neuritis. Since that time, unique biomarkers for optic neuritis have been found. The antibody against aquaporin-4 (AQP4)-immunoglobulin G (IgG) discovered in 2004 was found to be both the pathologic cause and a reliable biomarker for neuromyelitis optica spectrum disorders. This finding enabled an expanded definition of the phenotype of neuromyelitis optica spectrum disorder and improved treatment of the disease. Subsequently, myelin oligodendrocyte glycoprotein (MOG) IgG was recognized to be a marker for MOG-IgG-associated disorder, a central demyelinating disease characterized by recurrent optic neuritis, prominent disk edema, and perineural optic nerve enhancement on magnetic resonance imaging. Most multiple sclerosis disease-modifying agents are ineffective for AQP4-IgG-positive neuromyelitis optica spectrum disorder and MOG-IgG-associated disorder. Because there are crucial differences in treatment and prognosis between multiple sclerosis, AQP4-IgG-positive neuromyelitis optica spectrum disorder, and MOG-IgG-associated disorder, ophthalmologists should be aware of these new biomarkers of optic neuritis and incorporate their testing in all patients with atypical optic neuritis.",
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