Diagnostic value of intereye difference metrics for optic neuritis in aquaporin-4 antibody seropositive neuromyelitis optica spectrum disorders

Oertel, Frederike Cosima; Zimmermann, Hanna G; Motamedi, Seyedamirhosein; Chien, Claudia; Aktas, Orhan; Albrecht, Philipp; Ringelstein, Marius; Dcunha, Anitha; Pandit, Lekha; Martinez-Lapiscina, Elena H; Sanchez-Dalmau, Bernardo; Villoslada, Pablo; Palace, Jacqueline; Roca-Fernández, Adriana; Leite, Maria Isabel; Sharma, Srilakshmi M; Leocani, Letizia; Pisa, Marco; Radaelli, Marta; Lana-Peixoto, Marco Aurélio; Fontenelle, Mariana Andrade; Havla, Joachim; Ashtari, Fereshteh; Kafieh, Rahele; Dehghani, Alireza; Pourazizi, Mohsen; Marignier, Romain; Cobo-Calvo, Alvaro; Asgari, Nasrin; Jacob, Anu; Huda, Saif; Mao-Draayer, Yang; Green, Ari J; Kenney, Rachel; Yeaman, Michael R; Smith, Terry J; Cook, Lawrence; Brandt, Alexander U; Paul, Friedemann; Petzold, Axel

Abstract

Background: The novel optic neuritis (ON) diagnostic criteria include intereye differences (IED) of optical coherence tomography (OCT) parameters. IED has proven valuable for ON diagnosis in multiple sclerosis but has not been evaluated in aquaporin-4 antibody seropositive neuromyelitis optica spectrum disorders (AQP4+NMOSD). We evaluated the diagnostic accuracy of intereye absolute (IEAD) and percentage difference (IEPD) in AQP4+NMOSD after unilateral ON >6 months before OCT as compared with healthy controls (HC). Methods: Twenty-eight AQP4+NMOSD after unilateral ON (NMOSD-ON), 62 HC and 45 AQP4+NMOSD without ON history (NMOSD-NON) were recruited by 13 centres as part of the international Collaborative Retrospective Study on retinal OCT in Neuromyelitis Optica study. Mean thickness of peripapillary retinal nerve fibre layer (pRNFL) and macular ganglion cell and inner plexiform layer (GCIPL) were quantified by Spectralis spectral domain OCT. Threshold values of the ON diagnostic criteria (pRNFL: IEAD 5 µm, IEPD 5%; GCIPL: IEAD: 4 µm, IEPD: 4%) were evaluated using receiver operating characteristics and area under the curve (AUC) metrics. Results: The discriminative power was high for NMOSD-ON versus HC for IEAD (pRNFL: AUC 0.95, specificity 82%, sensitivity 86%; GCIPL: AUC 0.93, specificity 98%, sensitivity 75%) and IEPD (pRNFL: AUC 0.96, specificity 87%, sensitivity 89%; GCIPL: AUC 0.94, specificity 96%, sensitivity 82%). The discriminative power was high/moderate for NMOSD-ON versus NMOSD-NON for IEAD (pRNFL: AUC 0.92, specificity 77%, sensitivity 86%; GCIP: AUC 0.87, specificity 85%, sensitivity 75%) and for IEPD (pRNFL: AUC 0.94, specificity 82%, sensitivity 89%; GCIP: AUC 0.88, specificity 82%, sensitivity 82%). Conclusions: Results support the validation of the IED metrics as OCT parameters of the novel diagnostic ON criteria in AQP4+NMOSD.

Citation

Oertel, F. C., Zimmermann, H. G., Motamedi, S., Chien, C., Aktas, O., Albrecht, P., Ringelstein, M., Dcunha, A., Pandit, L., Martinez-Lapiscina, E. H., Sanchez-Dalmau, B., Villoslada, P., Palace, J., Roca-Fernández, A., Leite, M. I., Sharma, S. M., Leocani, L., Pisa, M., Radaelli, M., Lana-Peixoto, M. A., …Petzold, A. (2023). Diagnostic value of intereye difference metrics for optic neuritis in aquaporin-4 antibody seropositive neuromyelitis optica spectrum disorders. Journal of Neurology, Neurosurgery and Psychiatry, 94(7), 560-566. https://doi.org/10.1136/jnnp-2022-330608

• Journal Article Type: Article
• Acceptance Date: Feb 9, 2023
• Online Publication Date: Feb 21, 2023
• Publication Date: Jun 14, 2023
• Deposit Date: Mar 3, 2023
• Publicly Available Date: Mar 3, 2023
• Journal: Journal of Neurology, Neurosurgery & Psychiatry
• Print ISSN: 0022-3050
• Electronic ISSN: 1468-330X
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 94
• Issue: 7
• Pages: 560-566
• DOI: https://doi.org/10.1136/jnnp-2022-330608
• Public URL: https://durham-repository.worktribe.com/output/1177812