Background Myelin oligodendrocyte glycoprotein antibody-positive optic neuritis (MOG-ON) has been included in the Evidence-Based Guidelines for Diagnosis and Treatment of Demyelinating Optic Neuritis in China (2021) as a new type of optic neuritis, but there are few domestic clinical studies on MOG-ON in children.
Objective To study the clinical characteristics and prognosis of MOG-ON in children under 16 years old.
Methods Clinical data about 33 children (57 eyes) with MOG-ON diagnosed by the Department of Ophthalmology of the 942 Hospital of Chinese people's Liberation Army and the Eye Hospital of People's Hospital of Ningxia Hui Autonomous Region from January 2017 to December 2020 were analyzed retrospectively. The age of onset was 3-15 (9.9 ± 3.7) years old, and 16 cases were male. The clinical characteristics of the children and the recovery of visual acuity after treatment were collected.
Results There were 14 children (42.4%) with binocular optic neuritis as the first manifestation, 18 children (54.5%) had recurrence, and 24 children (72.7%) had bilateral onset at the last follow-up. At the first onset, 24 children (72.7%) accompanied with eye pain, and 23 eyes (48.9%) had optic disc edema. After 3 months of follow-up, OCT showed that the average thickness of peripheral optic disc nerve fiber layer (pRNFL) was (70.66 ± 11.11) μ m, and the average thickness of ganglion cell layer + inner plexus layer (mGCIPL) in macular region was (60.71 ± 7.14) μ m, showing varying degrees of atrophic thinning. Orbital MRI showed that the long T2 signal of the optic nerve was changed in 32 cases (97.0%), some of which were accompanied by optic nerve enhancement or perioptic nerve enhancement, and the optic chiasm was involved in 4 cases (12.1%). Within two weeks of the first onset, 37 eyes (78.7%) had best corrected visual acuity (BCVA) ≤ 0.1. After intravenous methylprednisolone treatment, visual function improved to varying degrees, and 46 eyes (97.9%) had BCVA≥0.5. The mean follow-up time was (34.06±17.60) months. At the last follow-up, 54 eyes (94.7%) had BCVA≥0.5.
Conclusion The clinical manifestations of MOG-ON in children under 16 years old are diverse. They are sensitive to corticosteroids pulse therapy, and most of them have a good prognosis.
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