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In this study, we investigated retinal atrophy patterns and diagnostic accuracy of optical coherence tomography (OCT) in differentiating between both diseases after the first ON episode.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients were retrospectively identified in eight tertial referral centers. OCT, VEP and high\/low-contrast visual acuity (HCVA\/LCVA) have been investigated\u2009&gt;\u20096\u00a0months after the first ON. Prevalence of pathological OCT findings was identified based on data of 144 age-matched healthy controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirteen MOGAD\n                      <jats:sup>ped<\/jats:sup>\n                      (10.7\u2009\u00b1\u20094.2\u00a0years, F:M 8:5, 21 ON eyes) and 21 MS\n                      <jats:sup>ped<\/jats:sup>\n                      (14.3\u2009\u00b1\u20092.4\u00a0years, F:M 19:2, 24 ON eyes) patients were recruited. We observed a significantly more profound atrophy of both peripapillary and macular retinal nerve fiber layer in MOGAD\n                      <jats:sup>ped<\/jats:sup>\n                      compared to MS\n                      <jats:sup>ped<\/jats:sup>\n                      (pRNFL global: 68.2\u2009\u00b1\u200916.9 vs. 89.4\u2009\u00b1\u200912.3\u00a0\u00b5m,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; mRNFL: 0.12\u2009\u00b1\u20090.01 vs. 0.14\u2009\u00b1\u20090.01 mm\n                      <jats:sup>3<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Neither other macular layers nor P100 latency differed. MOGAD\n                      <jats:sup>ped<\/jats:sup>\n                      developed global atrophy affecting all peripapillary segments, while MS\n                      <jats:sup>ped<\/jats:sup>\n                      displayed predominantly temporal thinning. Nasal pRNFL allowed differentiation between both diseases with the highest diagnostic accuracy (AUC\u2009=\u20090.902, cutoff\u2009&lt;\u200962.5\u00a0\u00b5m, 90.5% sensitivity and 70.8% specificity for MOGAD\n                      <jats:sup>ped<\/jats:sup>\n                      ). OCT was also substantially more sensitive compared to VEP in identification of ON eyes in MOGAD (pathological findings in 90% vs. 14%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>First MOGAD-ON results in a more severe global peripapillary atrophy compared to predominantly temporal thinning in MS-ON. Nasal pRNFL allows differentiation between both diseases with the highest accuracy, supporting the additional diagnostic value of OCT in children with ON.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00415-022-11256-y","type":"journal-article","created":{"date-parts":[[2022,7,23]],"date-time":"2022-07-23T01:04:08Z","timestamp":1658538248000},"page":"6366-6376","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Characteristic retinal atrophy pattern allows differentiation between pediatric MOGAD and MS after a single optic neuritis episode"],"prefix":"10.1007","volume":"269","author":[{"given":"T.","family":"Pakeerathan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Havla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Schwake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Salmen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Bigi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Abegg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Br\u00fcgger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Ferrazzini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.-K.","family":"Runge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Breu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Kornek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Bsteh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Felipe-Ruci\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Ringelstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Aktas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Karenfort","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Wendel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Kleiter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Hellwig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"K\u00fcmpfel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Thiels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"L\u00fccke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Gold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Rostasy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6009-792X","authenticated-orcid":false,"given":"I.","family":"Ayzenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,7,23]]},"reference":[{"key":"11256_CR1","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1016\/j.spen.2017.04.004","volume":"24","author":"MY Chang","year":"2017","unstructured":"Chang MY, Pineles SL (2017) Pediatric optic neuritis. 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Pakeerathan reports no disclosures relevant to the manuscript. J. Havla reports grants for OCT research from the Friedrich-Baur-Stiftung and Merck, personal fees and financial and non-financial support from Celgene, Merck, Alexion, Novartis, Roche, Santhera, Biogen, Heidelberg Engineering, Sanofi Genzyme and non-financial support of the Guthy-Jackson Charitable Foundation, all outside the submitted work. C. Schwake reports no disclosures relevant to the manuscript. A. Salmen reports speaker honoraria and\/or travel compensation for activities with Bristol Myers Squibb, CSL Behring, Novartis, and Roche, and research support by Baasch Medicus Foundation and the Swiss MS Society, all outside the submitted work. S. Bigi reports no disclosures relevant to the manuscript. M. Abegg reports no disclosures relevant to the manuscript. D. Br\u00fcgger reports no disclosures relevant to the manuscript. T. Ferrazzini reports no disclosures relevant to the manuscript. A-K. Runge reports no disclosures relevant to the manuscript. M. Breu received speaker honoraria from Sanofi Genzyme. B. Kornek received speaker honoraria from Bayer, Biogen, Celgene-BMS, Merck, Novartis, Roche, Sanofi Genzyme, and Teva and participated in advisory boards from Celgene-BMS, Merck, Novartis, Sanofi Genzyme, and Roche. No COIs related to this study. G. Bsteh has participated in meetings sponsored by, received speaker honoraria or travel funding from Biogen, Celgene\/BMS, Lilly, Merck, Novartis, Roche, Sanofi-Genzyme and Teva, and received honoraria for consulting Biogen, Celgene\/BMS, Novartis, Roche, Sanofi-Genzyme and Teva. He has received financial support in the past 12\u00a0months by unrestricted research grants (Celgene\/BMS, Novartis). A. Felipe-Ruci\u00e1n reports no disclosures relevant to the manuscript. M. Ringelstein received speaker honoraria from Novartis, Bayer Vital GmbH, Roche, Alexion and Ipsen and travel reimbursement from Bayer Schering, Biogen Idec, Merz, Genzyme, Teva, Roche, and Merck, none related to this study. O. Aktas received speaker and\/or consultation honoraria or travel funding from Alexion, Bayer Healthcare, Biogen, Celgene, Merck, Novartis, Roche, Sanofi Genzyme, VielaBio. M. Karenfort received personal honoraria from Novartis, not related to the content of this manuscript. E. Wendel reports no disclosures relevant to the manuscript. I. Kleiter received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Alexion, Biogen, Celgene, Hexal, Horizon, Merck and Roche\/Chuqai. K. Hellwig received speaker\u2019s, board honoraria, and research support from Bayer Schering, Biogen Idec, Genzyme, Merck Serono, Novartis, and Teva. Her department received grant support from Bayer Schering, Biogen Idec, Genzyme, Merck Serono, Novartis, Roche, and Teva. T. K\u00fcmpfel has received speaker honoraria and\/or personal fees for advisory boards from Novartis Pharma, Roche Pharma, Alexion and Biogen as well as grant support from Novartis and Chugai Pharma in the past. All not related to the content of this manuscript. C. Thiels reports no disclosures relevant to the manuscript. T. L\u00fccke has received speaker and board honoraria from Infectopharm, Novartis La Roche Ltd., Sanofi Genzyme, Proveca, Chiesi. His department received grant support from Takeda. All not related to this manuscript. R. Gold received speaker\u2019s and board honoraria from Baxter, Bayer Schering, Biogen Idec, CLB Behring, Genzyme, Merck Serono, Novartis, Stendhal, Talecris, and Teva. His department received grant support from Bayer Schering, Biogen Idec, Genzyme, Merck Serono, Novartis, and Teva. All not related to the content of this manuscript. K. Rostasy served as a consultant for the Operetta-Study\/Roche and received honoraria for lectures given for MERCK. I. Ayzenberg has received travel grants from Biogen Idec and Guthy-Jackson Charitable Foundation, served on scientific advisory boards for Roche and Alexion and received research support from Diamed, none related to this manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"Written informed consent was obtained from all patients and their legal representatives participating in the study. The local ethics committees approved the study protocol in accordance with the Declaration of Helsinki (1964) in its currently applicable version.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}]}}