Myelin oligodendrocyte glycoprotein antibody-associated optic neuritis and myelitis in COVID-19: a case report and a review of the literature

Colantonio, Mark A.; Nwafor, Divine C.; Jaiswal, Shruti; Shrestha, Ashish K.; Elkhooly, Mahmoud; Rollins, Steven; Wen, Sijin; Sriwastava, Shitiz

doi:10.1186/s41983-022-00496-4

Cited by 10 publications

(12 citation statements)

References 36 publications

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“…MRI brain and orbit revealed prechiasmatic enhancement of the left optic nerve, suggestive of optic neuritis. The MOG‐IgG antibody was positive and full recovery was achieved after treatment with intravenous and oral prednisolone 10 …”

Section: Discussionmentioning

confidence: 99%

Myelin oligodendrocyte glycoprotein antibody‐associated optic neuritis in a post‐COVID‐19 infection patient

Zaini,

Mohd Zain,

Md Din

et al. 2023

Immunity Inflam & Disease

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PurposeSARS‐CoV‐2 viral infection affects multiple systems including the respiratory, gastrointestinal, neurological, cardiac, and ophthalmic systems. We report a case of myelin oligodendrocyte glycoprotein (MOG) related optic neuritis in a SARS‐CoV‐2 (COVID‐19) patient.MethodsCase report.ResultsA 36‐year‐old Malay gentleman with underlying hypertension presented with the first episode of bilateral progressively worsening blurred vision for 1 week associated with retrobulbar pain. There were no other neurological symptoms. He had fever a week before the eye symptoms and tested positive for COVID‐19. He received COVID‐19 booster vaccine a month before the disease onset. On examination, his vision was hand motion on right eye and 6/18 on left eye. Relative afferent pupillary defect (RAPD) was positive on right eye with abnormal optic nerve function tests. Anterior segments were unremarkable. Fundus examination showed bilateral optic disc swelling. MRI revealed multifocal hyperintense subcortical white matter lesions. Optic nerves appeared normal with no enhancement seen. Blood investigation showed a positive serum MOG antibody. Intravenous methylprednisolone was commenced followed by oral prednisolone after which his vision and ocular symptoms markedly improved. The oral prednisolone was tapered alongside addition of azathioprine. At 1 month, the disease was stable with no recurrence.ConclusionWhile optic neuritis has been associated with both COVID‐19 infection and vaccination, MOG IgG antibody‐mediated optic neuritis is also a possible manifestation. This type of optic neuritis associated with COVID‐19 infection does not show a similar pattern of frequent recurrences as seen in non‐COVID‐19 related optic neuritis.

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Section: Discussionmentioning

confidence: 99%

Myelin oligodendrocyte glycoprotein antibody‐associated optic neuritis in a post‐COVID‐19 infection patient

Zaini,

Mohd Zain,

Md Din

et al. 2023

Immunity Inflam & Disease

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“…Infectious prodrome or vaccination within the last 30 days preceding disease was reported in about a third of patients. MOGAD after SARS-CoV-2 infection has already been described, [25][26][27][28] as well as MOGAD after COVID vaccination. [29][30][31] Two of our patients presented with MOGAD after COVID vaccination: a 22-year-old male, developed FLAMES about 3 weeks after receiving the Pfizer-BioNTech COVID-19 vaccination (►Figure 3); and a 43-year-old woman presented with transverse myelitis two weeks after receiving the Sinovac-CoronaVac vaccine.…”

Section: Discussionmentioning

confidence: 99%

Clinical spectrum of myelin oligodendrocyte glycoprotein antibody-associated disease in Brazil: a single-center experience

Messias,

Moreto,

Cruz

et al. 2023

Arq Neuropsiquiatr

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Background Anti-myelin oligodendrocyte glycoprotein (anti-MOG) antibody-associated disease (MOGAD) is an immune-mediated neurological disorder with a broad spectrum of clinical presentation that is often difficult to distinguish from other demyelinating diseases, such as multiple sclerosis and neuromyelitis optica spectrum disorder.Objective To describe the clinical and paraclinical characteristics of MOGAD in a Brazilian tertiary center.Methods We retrospectively reviewed the records of adult and pediatric patients who tested positive for anti-MOG antibodies and presented with clinical and radiological diseases compatible with MOGAD.Results Forty-one patients (10 children) were included: 56% female, 58% Caucasian, mean age at onset 31 years (range 6-64), with a mean disease duration of 59.6 months (range 1-264 months). The most frequent onset presentation was optic neuritis (68%), acute disseminated encephalomyelitis (ADEM, 12%), and myelitis (10%). A monophasic disease course was observed in 49%. EDSS median was 2.1 at the last visit. Most patients (83%) were under continuous immunosuppressive treatment. Azathioprine was the first-line treatment in 59%. In all ADEM cases, conus, and root involvement was radiologically observed on MRI.Conclusion Brazilian MOGAD patients presented with a similar spectrum of previously reported MOGAD phenotypes. Conus and spinal root involvement seems to be frequently present in MOGAD-ADEM and could serve as radiologic characteristics of this clinical entity.

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“…[5,14,[31][32][33] COVID-19 has also been the harbinger to optic neuritis in NMO spectrum disorder [4,17] and MOGrelated disease. [3,18,19,21,63,64] Optic neuritis in association with COVID-19 infection has also been reported in the pediatric age group even in the context of demyelinating conditions. [65] COVID-19related optic neuritis had a good response to intravenous (IV) corticosteroid therapy in all cases except four.…”

Section: Optic Neuritis and Other Optic Nerve Disordersmentioning

confidence: 97%

Neuro-ophthalmic Manifestations of Coronavirus Disease 2019 and Its Vaccination: A Narrative Review

Feizi

Isen

Tavakoli

2023

JOVR

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Coronavirus disease 2019 (COVID-19) is a current pandemic caused by SARS-CoV-2 that has vastly affected the whole world. Although respiratory disease is the most common manifestation of COVID-19, the virus can affect multiple organs. Neurotropic aspects of the virus are increasingly unfolding, in so far as some respiratory failures are attributed to brainstem involvement. The neuro-ophthalmic manifestations of COVID-19 and the neuro-ophthalmic side effects of vaccination were reviewed. The major findings are that the SARS-CoV-2 infection commonly causes headaches and ocular pain. It can affect the afferent and efferent visual pathways by ischemic or inflammatory mechanisms. Optic nerve may be the origin of transient or permanent visual loss from papillophlebitis, idiopathic intracranial hypertension, or optic neuritis. Cerebrovascular strokes are not uncommon and may lead to cortical visual impairment or optic nerve infarction. SARSCoV- 2 may affect the pupillomotor pathways, resulting in tonic pupil (Adie’s syndrome) or Horner’s syndrome. Cranial neuropathies including third, fourth, sixth, and seventh nerve palsies have all been reported. Rhino-orbital mucormycosis superinfections in COVID-19 patients receiving steroids or other immunosuppressive therapies may result in unilateral or bilateral visual loss and ophthalmoplegia. Autoimmune conditions such as Guillain- Barré, Miller-Fisher syndrome, and ocular myasthenia have been reported.

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Myelin oligodendrocyte glycoprotein antibody-associated optic neuritis and myelitis in COVID-19: a case report and a review of the literature

Cited by 10 publications

References 36 publications

Myelin oligodendrocyte glycoprotein antibody‐associated optic neuritis in a post‐COVID‐19 infection patient

Myelin oligodendrocyte glycoprotein antibody‐associated optic neuritis in a post‐COVID‐19 infection patient

Clinical spectrum of myelin oligodendrocyte glycoprotein antibody-associated disease in Brazil: a single-center experience

Neuro-ophthalmic Manifestations of Coronavirus Disease 2019 and Its Vaccination: A Narrative Review

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