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Astrocytic outer retinal layer thinning is not a feature in AQP4-IgG seropositive neuromyelitis optica spectrum disorders

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Item Type:Article
Title:Astrocytic outer retinal layer thinning is not a feature in AQP4-IgG seropositive neuromyelitis optica spectrum disorders
Creators Name:Lu, A. and Zimmermann, H.G. and Specovius, S. and Motamedi, S. and Chien, C. and Bereuter, C. and Lana-Peixoto, M.A. and Fontenelle, M.A. and Ashtari, F. and Kafieh, R. and Dehghani, A. and Pourazizi, M. and Pandit, L. and D'Cunha, A. and Kim, H.J. and Hyun, J.W. and Jung, S.K. and Leocani, L. and Pisa, M. and Radaelli, M. and Siritho, S. and May, E.F. and Tongco, C. and De Sèze, J. and Senger, T. and Palace, J. and Roca-Fernández, A. and Leite, M.I. and Sharma, S.M. and Stiebel-Kalish, H. and Asgari, N. and Soelberg, K.K. and Martinez-Lapiscina, E.H. and Havla, J. and Mao-Draayer, Y. and Rimler, Z. and Reid, A. and Marignier, R. and Cobo-Calvo, A. and Altintas, A. and Tanriverdi, U. and Yildirim, R. and Aktas, O. and Ringelstein, M. and Albrecht, P. and Tavares, I.M. and Bichuetti, D.B. and Jacob, A. and Huda, S. and Soto de Castillo, I. and Petzold, A. and Green, A.J. and Yeaman, M.R. and Smith, T.J. and Cook, L. and Paul, F. and Brandt, A.U. and Oertel, F.C.
Abstract:BACKGROUND: Patients with anti-aquaporin-4 antibody seropositive (AQP4-IgG+) neuromyelitis optica spectrum disorders (NMOSDs) frequently suffer from optic neuritis (ON) leading to severe retinal neuroaxonal damage. Further, the relationship of this retinal damage to a primary astrocytopathy in NMOSD is uncertain. Primary astrocytopathy has been suggested to cause ON-independent retinal damage and contribute to changes particularly in the outer plexiform layer (OPL) and outer nuclear layer (ONL), as reported in some earlier studies. However, these were limited in their sample size and contradictory as to the localisation. This study assesses outer retinal layer changes using optical coherence tomography (OCT) in a multicentre cross-sectional cohort. METHOD: 197 patients who were AQP4-IgG+ and 32 myelin-oligodendrocyte-glycoprotein antibody seropositive (MOG-IgG+) patients were enrolled in this study along with 75 healthy controls. Participants underwent neurological examination and OCT with central postprocessing conducted at a single site. RESULTS: No significant thinning of OPL (25.02±2.03 µm) or ONL (61.63±7.04 µm) were observed in patients who were AQP4-IgG+ compared with patients who were MOG-IgG+ with comparable neuroaxonal damage (OPL: 25.10±2.00 µm; ONL: 64.71±7.87 µm) or healthy controls (OPL: 24.58±1.64 µm; ONL: 63.59±5.78 µm). Eyes of patients who were AQP4-IgG+ (19.84±5.09 µm, p=0.027) and MOG-IgG+ (19.82±4.78 µm, p=0.004) with a history of ON showed parafoveal OPL thinning compared with healthy controls (20.99±5.14 µm); this was not observed elsewhere. CONCLUSION: The results suggest that outer retinal layer loss is not a consistent component of retinal astrocytic damage in AQP4-IgG+ NMOSD. Longitudinal studies are necessary to determine if OPL and ONL are damaged in late disease due to retrograde trans-synaptic axonal degeneration and whether outer retinal dysfunction occurs despite any measurable structural correlates.
Keywords:Aquaporin 4, Astrocytes, Autoantibodies, Cross-Sectional Studies, Neuromyelitis Optica, Optical Coherence Tomography, Retina
Source:Journal of Neurology Neurosurgery and Psychiatry
Publisher:BMJ Publishing Group
Page Range:188-195
Date:February 2022
Official Publication:https://doi.org/10.1136/jnnp-2021-327412
PubMed:View item in PubMed

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