Title : From darkness to sight: Rapid recovery in MOG-related optic neuritis with high-dose steroid therapy.
Abstract:
Objectives: To illustrate the rapid visual recovery in a patient with MOG optic neuritis through early, high-dose corticosteroid intervention.
Background: MOG optic neuritis is a severe inflammatory condition that can result in significant vision loss if not treated promptly. High-dose corticosteroids are known to aid recovery, though the degree of response varies. This case highlights the potential for near-complete vision restoration with prompt therapy, emphasizing its importance in clinical practice.
Case Description: A 30-year-old male of Pakistani origin presented with a 5-day history of blurred vision and mild pain in the left eye. His initial vision was 6/12, improving to 6/9 with pinhole testing. Over the next five days, his vision deteriorated to hand movements despite normal routine blood tests. Following a neuro-ophthalmology consultation, intravenous methylprednisolone (1g daily for 5 days) was initiated, followed by a tapering oral course. Vision improvement began by the third dose, reaching 6/6 with pinhole correction by day five. Color vision, initially reduced to 0/17 on Ishihara testing, was fully restored. OCT imaging and visual fields demonstrated significant recovery of both optic nerve function and vision. The patient tested positive for MOG antibodies and was referred to neurology for further assessment and ongoing care.
Conclusion: This case demonstrates the efficacy of high-dose corticosteroid therapy in rapidly restoring vision in severe MOG-related optic neuritis. Early intervention, supported by an interdisciplinary approach, can significantly improve outcomes and prevent lasting impairment. When investigating causes of optic neuritis, MOG antibody disease should be carefully considered, as timely diagnosis and treatment are essential for optimal recovery.
