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The neuro-ophthalmological manifestations of NMOSD and MOGAD—a comprehensive review

Eye volume 37, pages 2391–2398 (2023)Cite this article

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Abstract

Optic neuritis (ON) is one of the most frequently seen neuro-ophthalmic causes of vision loss worldwide. Typical ON is often idiopathic or seen in patients with multiple sclerosis, which is well described in the landmark clinical trial, the Optic Neuritis Treatment Trial (ONTT). However, since the completion of the ONTT, there has been the discovery of aquaporin-4 (AQP4) and myelin oligodendrocyte glycoprotein (MOG) antibodies, which are biomarkers for neuromyelitis optica spectrum disorder (NMOSD) and MOG antibody-associated disease (MOGAD), respectively. These disorders are associated with atypical ON that was not well characterised in the ONTT. The severity, rate of recurrence and overall outcome differs in these two entities requiring prompt and accurate diagnosis and management. This review will summarise the characteristic neuro-ophthalmological signs in NMOSD and MOGAD, serological markers and radiographic findings, as well as acute and long-term therapies used for these disorders.

摘要

视神经炎(ON)是全球最易导致视力下降的神经眼科疾病。据标志性的视神经治疗试验(ONTT)描述, 典型的ON通常为特发性或见于多发性硬化症的患者。然而, 自ONTT完成以来, 已经发现了水通道蛋白-4(AQP4)和髓磷脂少突胶质细胞糖蛋白(MOG)抗体, 它们分别是视神经脊髓炎疾病(NMOSD)和MOG抗体相关疾病 (MOGAD) 的生物标志物。ONTT中并没有很好的描述这些与非典型ON相关的疾病。这两类疾病的严重程度、复发率和最终临床结局不同, 需要及时准确的诊断和治疗。这篇综述将总结NMOSD和MOGAD的特异性的神经眼科体征、血清学标志物以及放射影像学法相, 以及对于这些疾病的急性和长期治疗。

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Fig. 1: 57-year-old male with AQP4-IgG positive neuromyelitis optica spectrum disorder (NMOSD) optic neuritis.
Fig. 2: 67-year-old female with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) optic neuritis.

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  1. Department of Ophthalmology and Neurology, Mayo Clinic, Rochester, MN, USA

    Negar Moheb & John J. Chen

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JJC and NM were involved in the study conception and design, review of the literature, drafting of the manuscript, and approval of the final version of the manuscript.

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Moheb, N., Chen, J.J. The neuro-ophthalmological manifestations of NMOSD and MOGAD—a comprehensive review. Eye 37, 2391–2398 (2023). https://doi.org/10.1038/s41433-023-02477-0

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