Longitudinal Retinal Changes in MOGAD

Frederike Cosima Oertel, Elias S. Sotirchos, Hanna G. Zimmermann, Seyedamirhosein Motamedi, Svenja Specovius, Eva Susanna Asseyer, Claudia Chien, Lawrence Cook, Eleni Vasileiou, Angeliki Filippatou, Peter A. Calabresi, Shiv Saidha, Lekha Pandit, Anitha D'Cunha, Olivier Outteryck, Hélène Zéphir, Sean Pittock, Eoin P. Flanagan, M. Tariq Bhatti, Paulus S. RommerGabriel Bsteh, Tobias Zrzavy, Tania Kuempfel, Orhan Aktas, Marius Ringelstein, Philipp Albrecht, Ilya Ayzenberg, Thivya Pakeerathan, Benjamin Knier, Lilian Aly, Nasrin Asgari, Kerstin Soelberg, Romain Marignier, Caroline Froment Tilikete, Alvaro Cobo Calvo, Pablo Villoslada, Bernardo Sanchez-Dalmau, Elena H. Martinez-Lapiscina, Sara Llufriu, Ari J. Green, Michael R. Yeaman, Terry J. Smith, Alexander U. Brandt, John Chen, Friedemann Paul*, Joachim Havla, with the GJCF International Clinical Consortium for NMOSD and the CROCTINO study group

*Corresponding author for this work

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OBJECTIVE: Patients with myelin oligodendrocyte glycoprotein antibody (MOG-IgG)-associated disease (MOGAD) suffer from severe optic neuritis (ON) leading to retinal neuro-axonal loss, which can be quantified by optical coherence tomography (OCT). We assessed whether ON-independent retinal atrophy can be detected in MOGAD.

METHODS: Eighty patients with MOGAD and 139 healthy controls (HCs) were included. OCT data was acquired with (1) Spectralis spectral domain OCT (MOGAD: N = 66 and HCs: N = 103) and (2) Cirrus high-definition OCT (MOGAD: N = 14 and HCs: N = 36). Macular combined ganglion cell and inner plexiform layer (GCIPL) and peripapillary retinal nerve fiber layer (pRNFL) were quantified.

RESULTS: At baseline, GCIPL and pRNFL were lower in MOGAD eyes with a history of ON (MOGAD-ON) compared with MOGAD eyes without a history of ON (MOGAD-NON) and HCs (p < 0.001). MOGAD-NON eyes had lower GCIPL volume compared to HCs (p < 0.001) in the Spectralis, but not in the Cirrus cohort. Longitudinally (follow-up up to 3 years), MOGAD-ON with ON within the last 6-12 months before baseline exhibited greater pRNFL thinning than MOGAD-ON with an ON greater than 12 months ago (p < 0.001). The overall MOGAD cohort did not exhibit faster GCIPL thinning compared with the HC cohort.

INTERPRETATION: Our study suggests the absence of attack-independent retinal damage in patients with MOGAD. Yet, ongoing neuroaxonal damage or edema resolution seems to occur for up to 12 months after ON, which is longer than what has been reported with other ON forms. These findings support that the pathomechanisms underlying optic nerve involvement and the evolution of OCT retinal changes after ON is distinct in patients with MOGAD. ANN NEUROL 2022;92:476-485.

Original languageEnglish
JournalAnnals of Neurology
Issue number3
Pages (from-to)476-485
Publication statusPublished - Sept 2022


  • Case-Control Studies
  • Cohort Studies
  • Humans
  • Immunologic Deficiency Syndromes/complications
  • Longitudinal Studies
  • Myelin-Oligodendrocyte Glycoprotein/immunology
  • Optic Neuritis/complications
  • Retina/diagnostic imaging
  • Retinal Degeneration/etiology
  • Retinal Neurons
  • Tomography, Optical Coherence/methods


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