The average thickness of the peripapillar retinal nerve fiber layer, ganglion cell layer, and inner plexiform layer in the eyes of patients with neuromyelitis optica spectrum disorders (NMOSD), who are aquaporin-4 immunoglobulin G antibody seropositive (AQP4-IgG+) is decreased, whether or not optic neuritis is present. 

The thinning of these layers in the eyes of patients with optic neuritis was comparable to that of patients with myelin oligodendrocyte glycoprotein antibody-associated demyelination with optic neuritis. 

The same was true for the eyes of patients who were AQP4-IgG+ but who had no optic neuritis and patients who had myelin oligodendrocyte glycoprotein antibody-associated demyelination but no optic neuritis.


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These are the findings of a new study published in the Journal of Neurology.

The study team set out to investigate retinal thickness in the eyes of AQP4-IgG+ patients with NMOSD with and without optic neuritis.

They identified 21 studies in the literature that included a total of 787 AQP4-IgG+ patients with NMOSD in which the primary measures were the average thickness of the peripapillary retinal nerve fiber layer and the combination of ganglion cell layer and inner plexiform layer at the macula.

The peripapillary retinal nerve fiber layer was thinner in the eyes of AQP4-IgG+ NMOSD with and without optic neuritis compared to healthy controls. The ganglion cell layer and the inner plexiform layer were also thinner in these patients.

Both layers were thinner in the eyes of AQP4-IgG+ patients with NMOSD with optic neuritis compared to patients with multiple sclerosis (MS) and optic neuritis. 

The thickness of the peripapillary retinal nerve fiber layer and ganglion cell layer, and the inner plexiform layer of AQP4-IgG+ patients with NMOSD without optic neuritis was similar to that of patients with MS without optic neuritis.

“These results might have important implications for understanding NMOSD mechanisms of different serostatus,” the author concluded. “[They] might provide some clues for developing new therapeutic approaches to promoting survival and axon regeneration of retinal ganglion cells in NMOSD patients.”

Reference

Huang L, Wang Y, Zhang R. Retina thickness in clinically affected and unaffected eyes in patients with aquaporin-4 immunoglobulin G antibody seropositive neuromyelitis optica spectrum disorders: a systematic review and meta-analysis. J Neurol. Published online November 10, 2022. doi:10.1007/s00415-022-11482-4