Abstract：
OBJECTIVE: Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a distinct CNS demyelinating disease. The rate of asymptomatic optic nerve enhancement on MRI has not been explored in patients with MOGAD. An improved understanding of this would guide clinical practice and assessment of treatment efficacy. We aimed to determine the frequency of asymptomatic optic nerve enhancement in MOGAD.
METHODS: This was a retrospective review of patients evaluated at Mayo Clinic with MOGAD between January 1, 2000, and August 1, 2021 (median follow-up 1.6 [range 1-19] years). MRI studies were reviewed by masked neuroradiologists. Scans performed within 30 days of ON attack were classified as attack scans. Images obtained for routine surveillance, before ON attack, or at the time of non-ON attack were classified as interattack scans.
RESULTS: Five hundred sixty-six MRIs (203 unique patients, 53% female) were included. Interattack MRIs represented 341 (60%) of the scans (median 36 days post-ON [range -1,032 to 6,001]). Of the interattack scans, 43 of 341 (13%), 30 unique patients, showed optic nerve enhancement. The enhancement was located at prior sites of ON in 35 of 43 (81%). Among the 8 patients with enhancement in new optic nerve areas, 6 had acute disseminated encephalomyelitis without an eye examination at the time of the MRI and 2 had preceding ON without imaging. Long-term visual outcomes showed no significant difference between those with and without asymptomatic enhancement, with improved visual acuity in most patients.
CONCLUSIONS: Asymptomatic optic nerve enhancement occurred in 13% of interattack MRIs, the majority in patients with prior ON and occurring at prior sites of optic nerve enhancement. New asymptomatic optic nerve enhancement in areas without prior ON was rare. These findings are important for understanding the natural history of MOGAD, the interpretation of symptoms or response to treatment, and the adjudication of attacks in clinical trials.
METHODS: This was a retrospective review of patients evaluated at Mayo Clinic with MOGAD between January 1, 2000, and August 1, 2021 (median follow-up 1.6 [range 1-19] years). MRI studies were reviewed by masked neuroradiologists. Scans performed within 30 days of ON attack were classified as attack scans. Images obtained for routine surveillance, before ON attack, or at the time of non-ON attack were classified as interattack scans.
RESULTS: Five hundred sixty-six MRIs (203 unique patients, 53% female) were included. Interattack MRIs represented 341 (60%) of the scans (median 36 days post-ON [range -1,032 to 6,001]). Of the interattack scans, 43 of 341 (13%), 30 unique patients, showed optic nerve enhancement. The enhancement was located at prior sites of ON in 35 of 43 (81%). Among the 8 patients with enhancement in new optic nerve areas, 6 had acute disseminated encephalomyelitis without an eye examination at the time of the MRI and 2 had preceding ON without imaging. Long-term visual outcomes showed no significant difference between those with and without asymptomatic enhancement, with improved visual acuity in most patients.
CONCLUSIONS: Asymptomatic optic nerve enhancement occurred in 13% of interattack MRIs, the majority in patients with prior ON and occurring at prior sites of optic nerve enhancement. New asymptomatic optic nerve enhancement in areas without prior ON was rare. These findings are important for understanding the natural history of MOGAD, the interpretation of symptoms or response to treatment, and the adjudication of attacks in clinical trials.
摘要：
目的：髓磷脂少突胶质细胞糖蛋白抗体相关疾病（MOGAD）是一种独特的中枢神经系统脱髓鞘疾病。MOGAD患者的MRI无症状视神经增强率尚未研究。对此的更好理解将指导临床实践和治疗效果的评估。我们旨在确定MOGAD中无症状视神经增强的频率。
方法：本研究是对2000年1月1日至2021年8月1日在梅奥诊所接受MOGAD评估的患者的回顾性研究（中位随访时间1.6[范围1-19]年）。MRI研究由蒙面神经放射学家进行审查。在开启攻击后30天内执行的扫描被归类为攻击扫描。为常规监测获得的图像，在攻击之前，或在非ON攻击时被分类为攻击间扫描。
结果：五百六十六MRI（203名独特患者，53%女性）被包括在内。攻击MRI代表341（60％）的扫描（中位36天后[范围-1,032至6,001]）。在互攻扫描中，341人中的43人（13%），30个独特的患者，显示视神经增强。增强位于43个中的35个（81％）的ON先前站点。在新视神经区增强的8例患者中，6例患有急性播散性脑脊髓炎，在MRI时没有进行眼部检查，2例之前没有成像。长期的视觉结果在有和没有无症状增强的患者之间没有显着差异，改善大多数患者的视力。
结论：有症状的视神经增强发生在13％的间歇MRI中，大多数发生在先前的ON和发生在先前的视神经增强部位的患者。在没有先前ON的区域中，新的无症状视神经增强很少见。这些发现对于了解MOGAD的自然史很重要，症状的解释或对治疗的反应，以及临床试验中攻击的裁决。
方法：本研究是对2000年1月1日至2021年8月1日在梅奥诊所接受MOGAD评估的患者的回顾性研究（中位随访时间1.6[范围1-19]年）。MRI研究由蒙面神经放射学家进行审查。在开启攻击后30天内执行的扫描被归类为攻击扫描。为常规监测获得的图像，在攻击之前，或在非ON攻击时被分类为攻击间扫描。
结果：五百六十六MRI（203名独特患者，53%女性）被包括在内。攻击MRI代表341（60％）的扫描（中位36天后[范围-1,032至6,001]）。在互攻扫描中，341人中的43人（13%），30个独特的患者，显示视神经增强。增强位于43个中的35个（81％）的ON先前站点。在新视神经区增强的8例患者中，6例患有急性播散性脑脊髓炎，在MRI时没有进行眼部检查，2例之前没有成像。长期的视觉结果在有和没有无症状增强的患者之间没有显着差异，改善大多数患者的视力。
结论：有症状的视神经增强发生在13％的间歇MRI中，大多数发生在先前的ON和发生在先前的视神经增强部位的患者。在没有先前ON的区域中，新的无症状视神经增强很少见。这些发现对于了解MOGAD的自然史很重要，症状的解释或对治疗的反应，以及临床试验中攻击的裁决。
