Optical coherence tomography angiography (OCTA) in differential diagnosis of aquaporin-4 antibody seronegative NMOSD and multiple sclerosis

•Differential diagnosis could be challenging in patients with optic neuritis as the initial symptom of demyelinating CNS disease, especially when the serum aquaporin-4 antibodies are negative.•Optical coherence tomography angiography(OCTA) is used to assess retinal microvascular network differences....

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Published in:Multiple sclerosis and related disorders 2022-02, Vol.58, p.103503-103503, Article 103503
Main Authors: Tiftikcioglu, Bedile Irem, Emre, Sinan, Idiman, Fethi, Idiman, Egemen
Format: Article
Language:English
Subjects:
Angiography
Aquaporin 4
aquaporin-4 antibody
Aquaporins
Diagnosis, Differential
Fluorescein Angiography - methods
Humans
Multiple Sclerosis - diagnosis
Neuromyelitis Optica
Neuromyelitis optica spectrum disorder
OCTA
optical coherence tomography angiography
relapsing-remitting multiple sclerosis
Retina
Retinal Vessels - diagnostic imaging
seronegative
Tomography, Optical Coherence - methods
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Summary:•Differential diagnosis could be challenging in patients with optic neuritis as the initial symptom of demyelinating CNS disease, especially when the serum aquaporin-4 antibodies are negative.•Optical coherence tomography angiography(OCTA) is used to assess retinal microvascular network differences.•OCTA reveal considerable differences between RRMS and NMOSD patients, particularly differentiating AQP4-ab negative patients during the initial insult.•OCTA might be a useful biomarker in differentiating NMOSD from RRMS. Optic neuritis(ON) is a common feature of both relapsing-remitting multiple sclerosis(RRMS) and neuromyelitis optica spectrum disorders(NMOSD). It is crucial to early differentiate these two diseases, as they differ in pathophysiology and treatment. To compare NMOSD and RRMS patients using optical coherence tomography(OCT) and OCT angiography(OCTA) to assess retinal microvascular network differences. Fourteen RRMS (28 eyes) and 9 NMOSD patients(18 eyes), and 11 controls were enrolled. Seropositivity for aquaporin-4 antibody (anti-AQP4 Abs) was 44.4%. Peripapillary and macular retinal nerve fiber layer(RNFL) thickness, superficial peripapillary and macular vessel density(VD), area, perimeter and circularity of foveal avascular zone(FAZ) were analyzed. OCTA showed reduction in peripapillary and macular VD and FAZ size in NMOSD+ON compared to RRMS+ON and controls (p = 0.001, p
ISSN:2211-0348
2211-0356
DOI:10.1016/j.msard.2022.103503