Clinical Spectrum of Ophthalmic Manifestations in Myelin Oligodendrocyte Glycoprotein-Associated Disease (MOGAD): A Comprehensive Case Report

Ocul Immunol Inflamm. 2024 Nov;32(9):2254-2260. doi: 10.1080/09273948.2024.2325053. Epub 2024 Mar 4.

Abstract

Purpose: To describe diverse ocular manifestations in a patient with Myelin oligodendrocyte glycoprotein-associated disease (MOGAD).

Methods: A 15-year-old Indian male had severe loss of vision in one eye, followed by a recurrent attack of optic neuritis in the fellow eye a few weeks later. He had a history of vision loss, speech disturbances, altered sensorium and was a confirmed case of Myelin oligodendrocyte glycoprotein-associated disease (MOGAD). Apart from optic neuritis, other rare ophthalmic associations, namely, macular neuroretinopathy, retinal haemorrhages, severe optic nerve head edema, peri neuritis, and orbital enhancement on magnetic resonance imaging (MRI) were noted.

Results: He responded dramatically to treatment with intravenous pulse steroids and relapses were controlled with long-term immunomodulation therapy.

Conclusion: This case report reiterates the need for early treatment with pulse steroids in MOGAD and depicts the heterogeneous involvement of various ocular structures in the disease.

Keywords: Acute macular neuroretinopathy; magnetic resonance imaging (MRI); myelin oligodendrocyte glycoprotein (MOG)-associated disease; optic neuritis; optical coherence tomography.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Glucocorticoids / therapeutic use
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Methylprednisolone / therapeutic use
  • Myelin-Oligodendrocyte Glycoprotein* / immunology
  • Optic Neuritis* / diagnosis
  • Optic Neuritis* / drug therapy
  • Papilledema / diagnosis
  • Papilledema / drug therapy
  • Papilledema / etiology
  • Retinal Hemorrhage / diagnosis
  • Retinal Hemorrhage / drug therapy
  • Retinal Hemorrhage / etiology
  • Tomography, Optical Coherence
  • Visual Acuity / physiology

Substances

  • Myelin-Oligodendrocyte Glycoprotein
  • Glucocorticoids
  • Methylprednisolone