RT Journal Article SR Electronic T1 Retinal Optical Coherence Tomography in Neuromyelitis Optica JF Neurology - Neuroimmunology Neuroinflammation JO Neurol Neuroimmunol Neuroinflamm FD Lippincott Williams & Wilkins SP e1068 DO 10.1212/NXI.0000000000001068 VO 8 IS 6 A1 Oertel, Frederike Cosima A1 Specovius, Svenja A1 Zimmermann, Hanna G. A1 Chien, Claudia A1 Motamedi, Seyedamirhosein A1 Bereuter, Charlotte A1 Cook, Lawrence A1 Lana Peixoto, Marco Aurélio A1 Fontanelle, Mariana Andrade A1 Kim, Ho Jin A1 Hyun, Jae-Won A1 Palace, Jacqueline A1 Roca-Fernandez, Adriana A1 Leite, Maria Isabel A1 Sharma, Srilakshmi A1 Ashtari, Fereshteh A1 Kafieh, Rahele A1 Dehghani, Alireza A1 Pourazizi, Mohsen A1 Pandit, Lekha A1 D'Cunha, Anitha A1 Aktas, Orhan A1 Ringelstein, Marius A1 Albrecht, Philipp A1 May, Eugene A1 Tongco, Caryl A1 Leocani, Letizia A1 Pisa, Marco A1 Radaelli, Marta A1 Martinez-Lapiscina, Elena H. A1 Stiebel-Kalish, Hadas A1 Siritho, Sasitorn A1 de Seze, Jérome A1 Senger, Thomas A1 Havla, Joachim A1 Marignier, Romain A1 Calvo, Alvaro Cobo A1 Bichuetti, Denis A1 Tavares, Ivan Maynart A1 Asgari, Nasrin A1 Soelberg, Kerstin A1 Altintas, Ayse A1 Yildirim, Rengin A1 Tanriverdi, Uygur A1 Jacob, Anu A1 Huda, Saif A1 Rimler, Zoe A1 Reid, Allyson A1 Mao-Draayer, Yang A1 Soto de Castillo, Ibis A1 Petzold, Axel A1 Green, Ari J. A1 Yeaman, Michael R. A1 Smith, Terry A1 Brandt, Alexander U. A1 Paul, Friedemann YR 2021 UL http://nn.neurology.org/content/8/6/e1068.abstract AB Background and Objectives To determine optic nerve and retinal damage in aquaporin-4 antibody (AQP4-IgG)-seropositive neuromyelitis optica spectrum disorders (NMOSD) in a large international cohort after previous studies have been limited by small and heterogeneous cohorts.Methods The cross-sectional Collaborative Retrospective Study on retinal optical coherence tomography (OCT) in neuromyelitis optica collected retrospective data from 22 centers. Of 653 screened participants, we included 283 AQP4-IgG–seropositive patients with NMOSD and 72 healthy controls (HCs). Participants underwent OCT with central reading including quality control and intraretinal segmentation. The primary outcome was thickness of combined ganglion cell and inner plexiform (GCIP) layer; secondary outcomes were thickness of peripapillary retinal nerve fiber layer (pRNFL) and visual acuity (VA).Results Eyes with ON (NMOSD-ON, N = 260) or without ON (NMOSD-NON, N = 241) were assessed compared with HCs (N = 136). In NMOSD-ON, GCIP layer (57.4 ± 12.2 μm) was reduced compared with HC (GCIP layer: 81.4 ± 5.7 μm, p < 0.001). GCIP layer loss (−22.7 μm) after the first ON was higher than after the next (−3.5 μm) and subsequent episodes. pRNFL observations were similar. NMOSD-NON exhibited reduced GCIP layer but not pRNFL compared with HC. VA was greatly reduced in NMOSD-ON compared with HC eyes, but did not differ between NMOSD-NON and HC.Discussion Our results emphasize that attack prevention is key to avoid severe neuroaxonal damage and vision loss caused by ON in NMOSD. Therapies ameliorating attack-related damage, especially during a first attack, are an unmet clinical need. Mild signs of neuroaxonal changes without apparent vision loss in ON-unaffected eyes might be solely due to contralateral ON attacks and do not suggest clinically relevant progression but need further investigation.AQP4-IgG=aquaporin-4 IgG; CROCTINO=Collaborative Retrospective Study on retinal OCT in Neuromyelitis Optica; EDSS=Expanded Disability Status Scale; GCIP=ganglion cell and inner plexiform; HC=healthy control; HC-VA=high-contrast visual acuity; INL=inner nuclear layer; MME=microcystic macular edema; MS=multiple sclerosis; MOG-IgG=myelin oligodendrocyte glycoprotein IgG; NMOSD=neuromyelitis optica spectrum disorder; NMOSD-NON=NMOSD eyes without a history of ON; OCT=optical coherence tomography; ON=optic neuritis; pRNFL=peripapillary retinal nerve fiber layer; SE=standard error; VA=visual acuity; VEP=visually evoked potential