Recurrent Optic Neuritis Associated With MOG Antibody Seropositivity

Area of Science:

• Neuroimmunology
• Ophthalmology

Background:

• Optic neuritis (ON) can be an initial sign of central nervous system autoimmune diseases like multiple sclerosis (MS) and neuromyelitis optica (NMO).
• Some ON cases involve antibodies against myelin oligodendrocyte glycoprotein (MOG).

Observation:

• A 50-year-old Sri Lankan female presented with recurrent, steroid-responsive ON.
• Neurological investigations were unremarkable, but MOG antibodies were positive, and AQP4 antibodies were negative.
• The patient experienced relapses upon steroid discontinuation but remained relapse-free with low-dose steroids and mycophenolate mofetil.

Findings:

• Recurrent ON can occur independently of MS and NMO in the presence of MOG antibodies.
• Long-term immunosuppression, including steroids and mycophenolate mofetil, is effective in maintaining remission.

Implications:

• This case expands the understanding of MOG antibody disease occurrence worldwide.
• Effective management strategies for MOG antibody-associated ON may involve steroid-based immunosuppression.