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著者: Jean-Baptiste Ducloyer, Angelique Caignard, Ramzi Aidaoui, Yolaine Ollivier, Guillaume Plubeau, Sonia Santos-Moskalyk, Lindsay Porphyre, Caroline Le Jeune, Lionel Bihl, Samy Alamine, Romain Marignier, Romain Bourcier, Mathilde Ducloyer, Michel Weber, Guylène Le Meur, Sandrine Wiertlewski, Pierre Lebranchu
雑誌名: Br J Ophthalmol. 2020 Jun;104(6):842-845. doi: 10.1136/bjophthalmol-2019-314845. Epub 2019 Oct 3.
Abstract/Text
OBJECTIVE: What is the proportion of antibodies to myelin oligodendrocyte glycoprotein (MOG-Ab) in optic neuritis (ON) in adults and what would be the ON presentation for which MOG-Ab should be tested?
METHODS: Multicentric prospective study conducted during 1 year on all patients diagnosed with acute ON in all ophthalmological units in hospitals in a region in western France.
RESULTS: Sixty-five patients were included. MOG-Ab prevalence was 14% (9/65) during an acute ON and 13% (7/55) after exclusion of patients already diagnosed with multiple sclerosis (MS) (8) or MOG+ON (2). Compared with MS and clinically isolated syndrome, MOG+ON had no female preponderance (67% of men in case of MOG+ON and 22% of men in case of MS and clinically isolated syndrome, p<0.05) were more often bilateral (44% vs 3%, p<0.005) and associated with optic disc swelling (ODS) (78% vs 14%, p<0.001). To predict MOG+ON, the positive predictive values (PPVs) of male sex, ODS and bilateral involvement were 29% (95% CI 9% to 48%), 41% (95% CI 18% to 65%) and 40% (95% CI 10% to 70%), respectively, while the negative predictive values (NPV) were 93% (95% CI 86% to 100%), 96% (95% CI 90% to 100%) and 91% (95% CI 83% to 99%), respectively. The combined factor 'ODS or bilateral or recurrent ON' was the best compromise between PPV (31% (95% CI 14% to 48%)) and NPV (100% (95% CI 100% to 100%)).
CONCLUSION: Among ON episodes, MOG-Ab were found in 14% of cases. MOG+ON occurred without female preponderance and was significantly associated with ODS and/or bilateral ON. Testing MOG-Ab only in patients presenting with ODS or bilateral or recurrent ON would limit MOG-Ab tests to fewer than half of all patients without the risk of missing any MOG+ON cases.
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
PMID 31582363 Br J Ophthalmol. 2020 Jun;104(6):842-845. doi: 10.1136/bjophthalmol-2019-314845. Epub 2019 Oct 3.
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