Optic Neuritis and NMOSD Diagnosis: Melanie Truong-Le, DO, OD

“Previously, we used ELISA [enzyme-linked immunosorbent assay] or the fluorescence sorting method to detect the antibodies, and we found that the sensitivity and specificity was not as high. So, with the use of cell-based assays, our detection rate for these antibodies is just so much more sensitive and specific, and that has helped us to diagnose, fully, these patients with more confidence. With that confidence, I think we are able to manage and treat them much more appropriately.”

Melanie Truong-Le, DO, OD, neuro-ophthalmologist, Peter O’Donnell Jr. Brain Institute, UT Southwestern Medical Center, sat down with NeurologyLive to discuss the clinical application of new technology for neuromyelitis optica spectrum disorder (NMOSD), as it relates to the treatment of optic neuritis. Truong-Le offered a unique perspective as a neuro-ophthalmologist, commenting on the use of optical coherence tomography (OCT), a noninvasive imaging technique using light rays to look at nerve fiber layer.

According to Truong-Le the pattern of thinning in the ganglion cell layer is different in NMOSD and multiple sclerosis, which is key for diagnosis. Further discussed were technological advances associated with aquaporin-4 antibody detection, as well as with the myelin oligodendrocyte glycoprotein antibody detection. Experts have veered away from the enzyme-linked immunosorbent assay (ELISA) and the fluorescence sorting method to identify these antibodies, Truong-Le said, in favor of cell-based assays to provide for more confident diagnoses.