Myelin Oligodendrocyte Glycoprotein antibody-associated disease (MOGAD): Optic Neuritis

We present a case of a 12 year old patient with no past medical history with one week of acute vision loss bilaterally. She was found to have bilateral severe optic disc edema, and MRI showed evidence of bilateral optic neuritis. MOG IgG serum testing returned positive, and the patient was diagnosed with Myelin Oligodendrocyte Glycoprotein antibody-associated disease (MOGAD) optic neuritis. She was treated initially with intravenous corticosteroids, and then with therapeutic plasmapheresis. At her two week clinic follow up, her vision had returned to baseline, and on examination she had trace temporal disc pallor of the right eye, with resolution of her optic disc edema bilaterally. This case illustrates characteristic features, diagnostic criteria, and treatment options for MOGAD in a pediatric patient.[1] Horton L, Bennett JL. Acute management of optic neuritis: An evolving paradigm. Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society. 38(3):358-367; [2.Sechi E, Cacciaguerra L, Chen JJ, Mariotto S, Fadda G, Dinoto A, Lopez-Chiriboga AS, Pittock SJ, Flanagan EP. Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD): A Review of Clinical and MRI Features, Diagnosis, and Management. Front Neurol. 2022 Jun 17;13:885218. doi: 10.3389/fneur.2022.885218. PMID: 35785363; PMCID: PMC9247462.; [3] Reindl M, Waters P. Myelin oligodendrocyte glycoprotein antibodies in neurological disease. Nat Rev Neurol. 2019;15(2):89-102. doi:10.1038/s41582-018-0112; [4] Shor N, Aboab J, Maillart E, et al. Clinical, imaging and follow‐up study of optic neuritis associated with myelin oligodendrocyte glycoprotein antibody: a multicentrestudy of 62 adult patients. EurJ Neurol. 2020;27(2):384-391. doi:10.1111/ene.14089; [5] DucloyerJ-B, CaignardA, Aidaoui R, et al. MOG-Ab prevalence in optic neuritis and clinical predictive factors for diagnosis. Br J Ophthalmol. October 2019:bjophthalmol-2019-314845. doi:10.1136/bjophthalmol-2019-314845; [6] in cooperation with the Neuromyelitis Optica Study Group (NEMOS), Jarius S, Ruprecht K, et al. MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 2: Epidemiology, clinical presentation, radiological and laboratory features, treatment responses, and long-term outcome. J Neuroinflammation. 2016;13(1):280. doi:10.1186/s12974-016-0718-