The demographic and clinical presentation of MOGAD Optic Neuritis in Alberta

Authors: Abdullah Al‐Ani, Etienne Benard‐Seguin, Saerom Youn, Jeremy Moreau, Fiona Costello. University of Calgary.

Author Disclosures: Abdullah Al‐Ani: None Etienne Benard‐Seguin: None Saerom Youn: None Jeremy Moreau: None Fiona Costello: None

Abstract Body: 

Purpose: Optic neuritis (ON) is a complex clinical syndrome often associated with central nervous system inflammatory disorders. While ON may be sporadic in nature or encountered in the setting of multiple sclerosis (MS), the discovery of new biomarkers, such as myelin oligodendrocyte glycoprotein (MOG)‐IgG and aquaporin‐4‐immunoglobulin G (AQP‐IgG), has enabled clinicians to define and further understand other subtypes. Herein, we evaluate the demographics and clinical presentation of patients with ON secondary to myelin oligodendrocyte glycoprotein antibody‐associated disease (MOGAD) in Alberta. 

Study Design: A retrospective study of patients referred for neuro‐ophthalmic consultation in Calgary, Alberta from 2008‐2022.

Methods: Through a detailed chart review of each patient, the following variables were collected: demographics (sex, age, and ethnicity); symptoms on presentation; investigations; and most responsible diagnosis. Final diagnosis was reviewed for all patients. Patients were excluded if a final diagnosis of MOGAD was not established with cell‐based assay techniques on serum samples, or if a final diagnosis was not recorded. Results: Data analysis identified 20 patients diagnosed with MOGAD. Of these patients, 11 (55%) were females and 9 (45%) were males. On first presentation, patients ranged between 4.4 and 52.8 years of age with an average age of 34.4 years. Additionally, 14 (70%) presented with ocular pain, while 8 (40%) presented with bilateral optic neuritis. Furthermore, 17 (85%) of patients presented with relative afferent pupillary defect. Ocular examination and ancillary tests on first presentation revealed that patients’ best‐corrected visual acuity ranged between light perception and 20/25, while their optical coherence tomography measured baseline retinal nerve fiber layer values ranged between 111 to 422 μm. Ongoing analysis of patients’ follow‐up visits will assess treatment outcomes. 

Conclusions: To the best of our knowledge, this is the first study that describes the demographic and clinical presentation of MOGAD ON in a Canadian population. This data establishes statistical evidence to inform clinical practice and prioritize investigations in the workup of ON. Continuing analysis of follow‐up will likely delineate treatment efficacy and identify prognostic factors for visual outcomes.

X