Antibodies to Myelin Oligodendrocyte Glycoprotein in Optic perineuritis

Shanshan Cao^1,2Yuan Zhang³Xintong Xu¹Mingming Sun¹Chunyan Pan³Yuhang Wang¹Wei Shihui¹Quangang Xu^1*Huanfen Zhou^1,4*

• ¹The Third Medical Center of Chinese PLA General Hospital, Beijing, China
• ²People's Liberation Army Air Force Special Medical Center, Beijing, China
• ³1st Medical Center of Chinese PLA General Hospital, Beijing, China
• ⁴Senior Department of Ophthalmology, Chinese PLA General Hospital, Beijing, China

This study investigated the prevalence of myelin oligodendrocyte glycoprotein antibodies (MOG-IgG) in optic perineuritis (OPN) and analyzed the clinical features and prognosis of MOG-IgG-seropositive cases. OPN patients diagnosed at the Neuro-ophthalmology Department of the Chinese People's Liberation Army (PLA) General Hospital between January 2020 and February 2023 were retrospectively reviewed and categorized into MOG-IgG–positive and seronegative groups based on cell-based assay (CBA) results. Our analysis included 33 patients (44 eyes), with a mean age of onset of 32.7 years (range 6-79) and a male-to-female ratio of 1:2. Bilateral involvement was present in 33.3% of cases. At presentation, 72.7% of patients reported eye pain, and 75.8% exhibited optic disc swelling. MOG-IgG was detected in 8 patients (24.2%). Compared to seronegative OPN, MOG-IgG-positive patients were significantly younger (mean age 20.8 years vs. 36.6 years, P = 0.034) and had a higher annual relapse rate (median 1.19 vs. 0.31, P = 0.008). Notably, all MOG-IgG-positive patients achieved visual acuity (VA) ≥20/40 after the first episode (100% vs. 45.5% in seronegative cases, P = 0.005), with this difference persisting at final follow-up (78.6% vs. 47.4%, P = 0.044). These findings highlight distinct clinical characteristics of MOG-IgG-positive OPN, including younger age, higher relapse rates, and superior visual recovery. Detection of MOG-IgG in OPN may facilitate early diagnosis, prognosis prediction, and the design of targeted therapies.