What's new in NMOSD and MOGAD?

Area of Science:

• Neuroimmunology
• Neurology
• Ophthalmology

Background:

• Neuromyelitis Optica Spectrum Disorders (NMOSD) and Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) are rare autoimmune conditions affecting the central nervous system.
• Advances in understanding antibody targets have refined diagnostic approaches.
• Significant knowledge gaps remain, particularly concerning seronegative presentations and optimal treatment strategies.

Purpose of the Study:

• To review novelties in NMOSD and MOGAD.
• To evaluate proposed MOGAD diagnostic criteria and their implications.
• To discuss the current understanding and unmet needs in seronegative NMOSD and explore acute treatment options for both conditions.

Main Methods:

• Mini-review of recent literature on NMOSD and MOGAD.
• Analysis of proposed MOGAD diagnostic criteria, including cerebrospinal fluid-only antibody positivity.
• Synthesis of current knowledge on seronegative NMOSD (nosology, clinical, biological, imaging features).

Main Results:

• Proposed MOGAD criteria require evaluation for limitations and impact on patient subgroups.
• The "double seronegative" NMOSD group presents diagnostic and therapeutic challenges.
• Current and future acute treatment strategies for NMOSD and MOGAD are discussed.

Conclusions:

• Refined diagnostic criteria for MOGAD are emerging, necessitating careful evaluation.
• Understanding and managing seronegative NMOSD remains a critical unmet need.
• Optimizing acute treatment is essential for improving outcomes in NMOSD and MOGAD.