Subclinical retinal atrophy in the unaffected fellow eyes of multiple sclerosis and neuromyelitis optica

•Retinal atrophy would be seen in MS-ON and AQP4-ON even in the unaffected eye.•Such retinal atrophy is still significant even after adjusting the possible biases.•Retinal thickness would be preserved in properly-treated MOG-ON and idiopathic ON.•Anti-AQP4-Ab titer could be associated with the latent retinal atrophy in AQP4-ON.•Follow-up of OCT study in the unaffected eye is recommended in MS-ON and AQP4-ON.

We compared the retinal thickness in the unaffected eyes among the following subtypes of unilateral optic neuritis (ON): multiple sclerosis (MS-ON), neuromyelitis optica spectrum disorder with anti-AQP4 autoantibody (AQP4-ON), patients with serum anti-MOG antibody (MOG-ON), and idiopathic ON. In the chronic phase, macular GCC and circum-papillary RNFL in the unaffected eyes were both atrophied in MS-ON and AQP4-ON, but were not atrophied in the others. Titers of anti-AQP4-Ab was suggested to be associated with such latent neurodegenerative process in AQP4-ON. Long-term follow up of OCT is recommended even in the unaffected side in MS-ON and AQP4-ON.

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