Macular vascular density alteration patterns in paediatric optic neuritis patients with serum MOG antibody positivity detected by optic coherence tomography angiography

Abstract

Abstract Purpose The retinal microvascular network plays a crucial role in inflammatory injury in paediatric optic neuritis (PON) with serum MOG antibody positivity (MOG+PON). This study compared retinal microvascular densities and structural alterations in MOG+PON eyes with paediatric isolated optic neuritis (PION) eyes and followed up with the final best-corrected visual acuity (BCVA) after 6 months. Methods A total of 29 children (52 eyes) with PON, including 15 MOG+PON cases (28 eyes), 6 PION cases (10 eyes), 2 neuromyelitis optica spectrum disorders associated PON(NMOSD-PON) cases (4 eyes), 6 MOG-associated disease (MOGAD) patients without ON-affected eyes (MOG+NPON) cases (10 eyes) and age- and gender-matched healthy controls (HCs) underwent superficial/deep retinal angiography density (SAD/DAD) by optical coherence tomography angiography (OCTA). Their BCVAs were followed up until 6 months after PON onsets. Results MOG+PON cases had better final BCVAs than PION and NMOSD-ON. MOG+PON (35.7 ± 10.3% ) and PION (40.1 ± 10.3%) eyes experienced severe SAD reductions in contrast to MOGAD+NPON (48.7 ± 5.2%) and HCs eyes (55.6 ± 8.2%). However, DAD in MOG+PON eyes (48.5 ± 9.2%) and MOG+NPON eyes (53.1 ± 3.3%) increased compared to HC eyes (45.7 ± 9.6%; p = 0.028 and 0.009, respectively). SAD reduction occurred in acute PON and was detected as early as 2 weeks after PON onset. Conclusions MOG+PON eyes had better final BCVAs than PION eyes, which displayed superficial retinal microvascular perfusion reductions and deep microvascular perfusion increases. SAD could be a sensitive surrogate for PON attacks in children with MOGAD.