Clinical Characteristics and Treatment of MOG-IgG-Associated Optic Neuritis

Curr Neurol Neurosci Rep. 2019 Nov 26;19(12):100. doi: 10.1007/s11910-019-1014-z.

Abstract

Purpose of review: Antibodies against myelin oligodendrocyte glycoprotein (MOG) are associated with a unique acquired central nervous system demyelinating disease-termed MOG-IgG-associated disorder (MOGAD)-which has a variety of clinical manifestations, including optic neuritis, transverse myelitis, acute disseminating encephalomyelitis, and brainstem encephalitis. In this review, we summarize the current knowledge of the clinical characteristics, neuroimaging, treatments, and outcomes of MOGAD, with a focus on optic neuritis.

Recent findings: The recent development of a reproducible, live cell-based assay for MOG-IgG, has improved our ability to identify and study this disease. Based on contemporary studies, it has become increasingly evident that MOGAD is distinct from multiple sclerosis and aquaporin-4-positive neuromyelitis optica spectrum disorder with different clinical features and treatment outcomes. There is now sufficient evidence to separate MOGAD from other inflammatory central nervous system demyelinating disorders, which will allow focused research on understanding the pathophysiology of the disease. Prospective treatment trials are needed to determine the best course of treatment, and until then, treatment plans must be individualized to the clinical manifestations and severity of disease.

Keywords: Acute disseminating encephalomyelitis (ADEM); Aquaporin-4 (AQP4); Multiple sclerosis; Myelin oligodendrocyte glycoprotein (MOG); Neuromyelitis optica spectrum disorder (NMOSD); Optic neuritis.

Publication types

  • Review

MeSH terms

  • Aquaporin 4 / blood
  • Aquaporin 4 / immunology
  • Autoantibodies / blood*
  • Autoantibodies / immunology
  • Humans
  • Immunoglobulin G / blood*
  • Immunoglobulin G / immunology
  • Myelin-Associated Glycoprotein / blood
  • Myelin-Associated Glycoprotein / immunology
  • Myelin-Oligodendrocyte Glycoprotein / blood*
  • Myelin-Oligodendrocyte Glycoprotein / immunology
  • Neuroimaging / methods
  • Neuromyelitis Optica / blood
  • Neuromyelitis Optica / diagnostic imaging
  • Neuromyelitis Optica / immunology
  • Optic Neuritis / blood*
  • Optic Neuritis / diagnostic imaging*
  • Optic Neuritis / immunology
  • Prospective Studies
  • Treatment Outcome

Substances

  • Aquaporin 4
  • Autoantibodies
  • Immunoglobulin G
  • MAG protein, human
  • MOG protein, human
  • Myelin-Associated Glycoprotein
  • Myelin-Oligodendrocyte Glycoprotein