![]() Ninety patients with iON were identified. The remaining patients, who were not excluded, were diagnosed as isolated ON. Of the 214 patients with symptomatic ON, patients with multiple sclerosis, neuromyelitis optica spectrum disorder (NMOSD) with or without AQP4-IgG, acute disseminated encephalomyelitis, and patients with symptomatic CNS lesions other than on the optic nerve were excluded from this study. MRI imaging and blood sampling were performed. ![]() A diagnosis of ON was made on the basis of acute visual symptoms such as decreased visual acuity or visual field defect and evidence of an afferent pupillary defect in the affected eye. Patients with acute visual symptoms were evaluated by an experienced neurologist and an ophthalmologist. ![]() The diagnosis, clinical characteristics, and laboratory findings of patients were reviewed by HJL and SMK. In the present study, we investigated the frequency of CRION and MOG IgG1 antibodies in patients with isolated ON (iON) and compared CRION and non-CRION-MOG-IgG-positive patients.Ī total of 615 consecutive patients identified between 20 with IDDs of the CNS were screened from the prospectively collated database of Seoul National University’s Multiple Sclerosis/Neuromyelitis Optica Center in South Korea. Although the features of MOG-IgG-associated diseases are similar to those of CRION, the relevance of the current CRION diagnostic criteria with MOG-IgG seropositivity has not been well studied. Characteristics of MOG-IgG-associated diseases include optic neuritis as a major symptom, good response to steroid, absence of serum AQP4-Ab, and steroid-dependent relapse or disease exacerbation. The antibody to myelin oligodendrocyte glycoprotein (MOG-Ab) has been proposed as a new marker of inflammatory demyelinating diseases (IDDs) of the central nervous system (CNS). reviewed 122 case reports and proposed the diagnostic criteria of CRION by adding radiological and laboratory findings: enhancement of the optic nerve on magnetic resonance imaging (MRI) and the absence of aquaporin-4 antibodies (AQP4-Ab). Among iON patients with MOG-IgG, the absence of steroid-dependent attacks in the early stages of the disease may predict a long-term non-relapsing disease course and a more favorable outcome.Ĭhronic relapsing inflammatory optic neuropathy (CRION), initially described in 2003, is a form of recurrent optic neuritis (ON) that has relatively good response/dependency to steroid treatment. ConclusionsĬRION, according to the current diagnostic criteria, is a relapsing optic neuritis associated with MOG-IgG. However, patients in the two groups did not differ in terms of age of onset, sex, or steroid treatment duration after initial attack. CRION patients with MOG-IgG had more relapsing disease courses (first steroid-dependent worsening/relapse in 2.3 months, range 0.4–7.0) and poorer optical coherence tomography outcomes at follow-up than non-CRION patients with MOG-IgG. Among the other 52 iON patients not meeting the criteria for CRION, 14 had relapsing disease courses and 38 had monophasic courses, of which MOG-IgG positivity were 0% and 29%, respectively. Twelve iON patients fulfilled the current diagnostic criteria for CRION, 11 patients were positive for MOG-IgG, and one patient was borderline. Fulfillment of the current diagnostic criteria for CRION, assay results for the serum IgG1 MOG-Ab, and characteristics of CRION patients with MOG-IgG were compared to those of non-CRION patients with MOG-IgG. Sixty-four patients with iON, who did not meet the diagnostic criteria for multiple sclerosis, neuromyelitis optica (NMO) spectrum disorder with/without NMO-IgG, or acute disseminated encephalomyelitis and who had no symptomatic central nervous system (CNS) lesions other than on the optic nerve, were included from a cohort of 615 patients with inflammatory demyelinating diseases of the CNS. Retrospective reviews of a database prospectively collated between 20 from the tertiary referral center for multiple sclerosis and neuromyelitis optica were performed. ![]() We investigated the relevance of the presence of serum MOG-IgG with the current diagnostic criteria for CRION among patients with idiopathic inflammatory optic neuritis (iON). Key clinical features of chronic relapsing inflammatory optic neuropathy (CRION) include relapsing inflammatory optic neuritis (ON) and steroid dependency, both of which have been reported among patients with myelin oligodendrocyte glycoprotein antibodies (MOG-Abs).
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