Neurological Spectrum Disorders Associated with Anti–MOG Antibody
Optic neuritis (ON) is an inflammatory disease of the optic nerve characterized by pain and visual loss
and often associated with multiple sclerosis (MS) or neuromyelitis optica spectrum disorders (NMOSD).
Autoantibodies against myelin oligodendrocyte glycoprotein (MOG-IgG) have been reported in patients
with inflammatory central nervous system disorders including isolated optic neuritis (ON).
Objective: To investigate the differences of clinical features, cerebrospinal fluid (CSF), MRI findings and
response to steroid therapies between patients with optic neuritis (ON) who have myelin oligodendrocyte
glycoprotein (MOG) antibodies and seronegative group. This study was done in a period between June
2015 and July 2018, 65 patients were included in this study with ON who ophthalmologists had diagnosed
as having or suspected to have ON with acute visual impairment and declined critical flicker frequency,
abnormal findings of brain MRI, optical coherence tomography and fluorescein fundus angiography at their
onset or recurrence. After exclusion of all patients who fulfilled the diagnostic criteria of neuromyelitis
optica (NMO)/NMO spectrum disorders (NMOSD), MS McDonald’s criteria, we defined 40 patients with
idiopathic ON (12 males, 28 females, age range 15-60 years). Sera from patients were tested for antibodies
to MOG and aquaporin-4 (AQP4) with a cell-based assay.
Results: 37.5% (15/40) were positive for MOG antibodies, 2.5% (1/40) were positive for AQP4 and 25
(62.5%) were seronegative. Among the 15 patients with MOG antibodies, four had optic pain (p=0.007) and
five had prodromal infection (p=0.05). Two of the 15 MOG-positive patients showed significantly high CSF
levels of myelin basic protein (p=0.05) and none were positive for oligoclonal band in CSF. On MRIs, five
MOG-positive patients showed high signal intensity on optic nerve, four had a cerebral lesion and two had a
spinal cord lesion. Six of the eight MOG-positive patients had a good response to steroid therapy.
Conclusions: The present results indicate that Patients with NMOSD and MOG positive antibodies have
distinct clinical features, fewer attacks and better recovery than seronegative patients.