Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Beyond MOG and AQP4 Antibodies: Alternative Causes of Optic Neuritis

Giacomo Greco
ORCID logo ,
Elena Colombo
,
Matteo Gastaldi
,
Lara Ahmad
,
Eleonora Tavazzi
ORCID logo ,
Roberto Bergamaschi
ORCID logo ,
Eleonora Rigoni
*
Version 1 : Received: 3 October 2023 / Approved: 3 October 2023 / Online: 3 October 2023 (10:52:57 CEST)

A peer-reviewed article of this Preprint also exists.

Greco, G.; Colombo, E.; Gastaldi, M.; Ahmad, L.; Tavazzi, E.; Bergamaschi, R.; Rigoni, E. Beyond Myelin Oligodendrocyte Glycoprotein and Aquaporin-4 Antibodies: Alternative Causes of Optic Neuritis. Int. J. Mol. Sci. 2023, 24, 15986. Greco, G.; Colombo, E.; Gastaldi, M.; Ahmad, L.; Tavazzi, E.; Bergamaschi, R.; Rigoni, E. Beyond Myelin Oligodendrocyte Glycoprotein and Aquaporin-4 Antibodies: Alternative Causes of Optic Neuritis. Int. J. Mol. Sci. 2023, 24, 15986.

Abstract

Optic neuritis (ON) is the most common cause of vision loss in young adults. It manifests as acute or subacute vision loss, often accompanied by retrobulbar discomfort or pain on eye movements. Typical ON is associated with Multiple Sclerosis and is generally mild and steroid-responsive, whereas atypical forms are characterized by unusual features, such as optic disc edema, poor treatment response and bilateral involvement, and are often associated with autoantibodies against aquaporin-4 (AQP4) and Myelin Oligodendrocyte Glycoprotein (MOG). However, in rare cases AQP4 and MOG antibodies will come back negative, plunging the clinician in a diagnostic conundrum. Seronegative ON warrants a broad differential diagnosis, including autoantibody-associated, granulomatous, and systemic disorders. These rare forms need to be identified promptly, as their management and prognosis is greatly different. The scope of this review is to describe possible, rarer etiologies of ON when AQP4 and MOG antibodies are negative and discuss their diagnosis and treatment.

Keywords

neuro-ophthalmology; optic neuritis; visual loss; AQP4; MOG; GFAP; CRION; sarcoidosis; optic perineuritis

Subject

Medicine and Pharmacology, Neuroscience and Neurology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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