OCT-Based Differentiation of First Acute Optic Neuritis: An International Study of 111 Patients With NMOSD and MOGAD
Issued Date
2026-03-01
Resource Type
eISSN
23327812
Scopus ID
2-s2.0-105026946295
Pubmed ID
41499724
Journal Title
Neurology R Neuroimmunology Neuroinflammation
Volume
13
Issue
2
Rights Holder(s)
SCOPUS
Bibliographic Citation
Neurology R Neuroimmunology Neuroinflammation Vol.13 No.2 (2026) , e200531
Suggested Citation
Pakeerathan T., Davis J., Henderson A.D., Sotirchos E.S., Said Y., Havla J., Ringelstein M., Aktas O., Weise M., Gernert J.A., Kornek B., Bsteh G., Rommer P.S., Krajnc N., Pröbstel A.K., Papadopoulou A., Kulsvehagen L., Pretzsch R., Schoenholzer K., Padungkiatsagul T., Moss H.E., Villarreal Navarro S.E., Herwerth M., Graure M., Kana V., Stiebel-Kalish H., Zlatkin R., Arnold A.C., Bonelli L., Stellmann J.P., Stolowy N., Schwake C., Schneider-Gold C., Kümpfel T., Albrecht P., Rattanathamsakul N., Pittock S.J., Flanagan E.P., Carta S., Mariotto S., Gold R., Chen J.J., Ayzenberg I. OCT-Based Differentiation of First Acute Optic Neuritis: An International Study of 111 Patients With NMOSD and MOGAD. Neurology R Neuroimmunology Neuroinflammation Vol.13 No.2 (2026) , e200531. doi:10.1212/NXI.0000000000200531 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/114493
Title
OCT-Based Differentiation of First Acute Optic Neuritis: An International Study of 111 Patients With NMOSD and MOGAD
Author(s)
Pakeerathan T.
Davis J.
Henderson A.D.
Sotirchos E.S.
Said Y.
Havla J.
Ringelstein M.
Aktas O.
Weise M.
Gernert J.A.
Kornek B.
Bsteh G.
Rommer P.S.
Krajnc N.
Pröbstel A.K.
Papadopoulou A.
Kulsvehagen L.
Pretzsch R.
Schoenholzer K.
Padungkiatsagul T.
Moss H.E.
Villarreal Navarro S.E.
Herwerth M.
Graure M.
Kana V.
Stiebel-Kalish H.
Zlatkin R.
Arnold A.C.
Bonelli L.
Stellmann J.P.
Stolowy N.
Schwake C.
Schneider-Gold C.
Kümpfel T.
Albrecht P.
Rattanathamsakul N.
Pittock S.J.
Flanagan E.P.
Carta S.
Mariotto S.
Gold R.
Chen J.J.
Ayzenberg I.
Davis J.
Henderson A.D.
Sotirchos E.S.
Said Y.
Havla J.
Ringelstein M.
Aktas O.
Weise M.
Gernert J.A.
Kornek B.
Bsteh G.
Rommer P.S.
Krajnc N.
Pröbstel A.K.
Papadopoulou A.
Kulsvehagen L.
Pretzsch R.
Schoenholzer K.
Padungkiatsagul T.
Moss H.E.
Villarreal Navarro S.E.
Herwerth M.
Graure M.
Kana V.
Stiebel-Kalish H.
Zlatkin R.
Arnold A.C.
Bonelli L.
Stellmann J.P.
Stolowy N.
Schwake C.
Schneider-Gold C.
Kümpfel T.
Albrecht P.
Rattanathamsakul N.
Pittock S.J.
Flanagan E.P.
Carta S.
Mariotto S.
Gold R.
Chen J.J.
Ayzenberg I.
Author's Affiliation
Stanford University
Johns Hopkins University
Mayo Clinic
Tel Aviv University
Universität Bonn
Medizinische Universität Wien
Klinikum der Universität München
Heinrich-Heine-Universität Düsseldorf
Università degli Studi di Verona
Universitätsspital Basel
Hopital La Timone
Siriraj Hospital
Deutsches Zentrum für Neurodegenerative Erkrankungen
Wilmer Eye Institute
UCLA Stein Eye Institute
Faculty of Medicine Ramathibodi Hospital, Mahidol University
St. Josef-Hospital im Katholischen Klinikum Bochum
Heinrich-Heine-Universität Düsseldorf Medizinische Fakultät
Universitätsspital Zürich, Klinik für Neurologie
Centre de Résonance Magnétique Biologique et Médicale
Maria Hilf Clinics Mönchengladbach
Johns Hopkins University
Mayo Clinic
Tel Aviv University
Universität Bonn
Medizinische Universität Wien
Klinikum der Universität München
Heinrich-Heine-Universität Düsseldorf
Università degli Studi di Verona
Universitätsspital Basel
Hopital La Timone
Siriraj Hospital
Deutsches Zentrum für Neurodegenerative Erkrankungen
Wilmer Eye Institute
UCLA Stein Eye Institute
Faculty of Medicine Ramathibodi Hospital, Mahidol University
St. Josef-Hospital im Katholischen Klinikum Bochum
Heinrich-Heine-Universität Düsseldorf Medizinische Fakultät
Universitätsspital Zürich, Klinik für Neurologie
Centre de Résonance Magnétique Biologique et Médicale
Maria Hilf Clinics Mönchengladbach
Corresponding Author(s)
Other Contributor(s)
Abstract
BACKGROUND AND OBJECTIVES: Severe optic neuritis (ON) is a common clinical manifestation in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) and neuromyelitis optica spectrum disorder (NMOSD). Given distinct prognoses and often the necessity of early plasma exchange in NMOSD, prompt differentiation is crucial. In this study, we investigated the utility of optical coherence tomography (OCT) in differentiating between first acute NMOSD-ON and MOGAD-associated optic neuritis (MOGAD-ON), as well as specific factors associated with disc edema. METHODS: In this retrospective multicenter study, 111 adult patients with MOGAD or aquaporin-4 antibody-positive NMOSD who experienced a first ON and underwent OCT within 2 weeks of symptom onset were included from 14 centers across 8 countries. Peripapillary retinal nerve fiber layer (pRNFL) thickness in µm was analyzed, including the average of both eyes in cases of bilateral manifestation. RESULTS: Eighty-three patients with MOGAD (51 women; 124 ON eyes; bilateral ON 48.2%) and 28 with NMOSD (24 women; 36 ON eyes; bilateral ON 21.4%) were enrolled. A significant increase in pRNFL thickness (>2SD), suggestive of disc edema, was observed in 73.4% of MOGAD-ON eyes and 11.1% of NMOSD-ON eyes (p < 0.001). The pRNFL thickness cutoff of 117.5 µm provided 92.9% specificity and 71.1% sensitivity in distinguishing between MOGAD-ON and NMOSD-ON (area under the curve = 0.838). There was no association between pRNFL thickening and MOG-IgG titer (high vs low), body mass index, or the delay between ON onset and OCT. Simultaneous bilateral MOGAD-ON was associated with significantly more pronounced pRNFL thickening. DISCUSSION: Acute-stage OCT contributes to the rapid and accurate differentiation between MOGAD-ON and NMOSD-ON prior to antibody confirmation, which can be critical for timely therapeutic decisions.