[Effects of different treatment and prevention regimens on myelin oligodendrocyte glycoprotein antibody-related optic neuritis].

Objective

To compare the effects of different treatment and prevention regimens on recovery and relapse rate in patients with myelin oligodendrocyte glycoprotein antibody-related optic neuritis (MOG-ON).

Methods

Retrospective study of the records of 37 patients with MOG-ON in ZhongShan Ophthalmology Center from January 2014 to December 2018. Patients with first-ever MOG-ON (first-ever group) were subdivided into intravenous methylprednisolone pulse group (Pulse group) and high dose methylprednisolone without pulse regimen group (non-pulse group). Comparisons were taken on visual acuity (VA), visual field (VF), visual evoked potential amplitude (VEP) and retinal nerve fiber layer thickness (RNFLT). Effect of different prevention regimens, either low dose prednisone or low dose of prednisone (2.5-10 mg/Day) combined with mycophenolate mofetil (MMF) (0.5-1 g/Day) , as well as the annual relapse rate (ARR) were compared.

Results

Among 25 patients of first-ever MOG-ON group (19 patients in pulse group and 6 patients in non-pulse group), VF of pulse group showed significant recovery, with MD value of (-7±8) dB at 1 m after onset and (-26±11) dB at onset (P<0.01), while non-pulse group showed significant VF recovery only at 6 m after onset, with MD value of (-9±9) dB at 6 m and (-22±11) dB at onset (P<0.01). However, no significant difference of VA, VF, VEP and RNFL could be found between the two groups on at all follow-up time points (P>0.05). Among 12 patients with at least one relapse (relapse group), 9 patients (75%) were given low-dose of prednisone plus MMF for relapse prevention. The ARR was 0.77 (0.21-4.5) before and 0 (0-0.41) after the regimen, respectively (P<0.05).

Conclusion

Intravenous methylprednisolone pulse therapy in acute phase of MOG-ON may accelerate the recovery of visual function and improve the prognosis. Low-dose of prednisone combined with MMF may reduce the recurrence rate of MOG-ON.