Macular vascular density alteration patterns in Pediatric optic neuritis patients with serum MOG antibody positivity detected by optic coherence tomography angiography

Purpose: Retinal microvascular net played a crucial role in inflammatory injury of pediatric optic neuritis(PON) with serum MOG antibody positivity (MOG+PON). This study compared retinal microvascular density and structural alterations in MOG+PON eyes with pediatric isolated optic neuritis (PION) eyes, and followed up the final best-corrected visual acuity (BCVA) at least 6 months. Methods: 23 children (42 eyes) with PON including 15 MOG+PON cases (28 eyes), 6 PION cases (10 eyes), NMOSD-PON 2 cases (4 eyes), MOG associated diseases (MOGAD) patients without ON affected eyes (MOG+NPON) 6 cases (10 eyes) and age-gender matched healthy controls (HCs) underwent superficial/deep retinal angiography density (SAD/DAD) and retinal structure quantitively evaluation by optical coherence tomography angiography (OCTA) after fully ophthalmological examinations. And their BCVA was followed up until 6 months after ON onsets. Results: MOG+PON eyes had better final BCVA, which (35.7±10.3%) suffered severity SAD reduction as well as PION eyes(40.1±10.3%) in contrast to that of MOGAD-NPON （48.7±5.2%）and HCs eyes（55.6±8.2） (P=0.000 and 0.000 respectively). However, DAD in MOG+PON eyes (48.5±9.2%) and MOG+NPON eyes (53.1±3.3%) displayed increasing compared with HCs eyes (45.7±9.6%) (p= 0.028, 0.009 respectively). SAD reduction in PON eyes occurred at acute PON, which can be detected reduction at 2 weeks after PON onsets. Conclusions: MOG+PON eyes had better final BCVA than PION eyes, which displayed retinal superficial microvascular perfusion reduction and deep microvascular perfusion increases. SAD could be sensitive surrogate to PON attacks in MOGAD children.