![]() Flash visual evoked potential (F-VEP) showed P-wave, at 1.0 Hz, prolonged (130.6 ms) and electric voltage decreased (8.96 μV). Fundus fluorescein angiography reminded diffuse high fluorescence leakage and linear low fluorescence in left optic disc (Fig. The average peripapillary retinal nerve fiber layer (RNFL) thickness of left eye increased to 347 μm (Fig. Diffuse disc swelling and vascular angiectasis with linear hemorrhage around optic disc were captured on Fundus photography (Fig. Perimetrical Test showed only small residual view remained in the nasal quadrant (Fig. The VA of the left eye was couting finger at 15 cm with relative afferent pupillary defect, while the VA of the right eye remained 1.0. Her past medical history included 15-years hypertension and lumbar decompression in 2002. Although she was treated by Pred Forte Eye Drop for 5 days, followed by retrobulbar injection of Racanisodamine Hydrochloride, the VA continued to decline. Later, the VA of the left eye decreased to 0.4 (logarithmic visual acuity chart) and an edematous optic disc was found on ophthalmoscopy. She caught a cold 5 days before the ophthalmological symptoms set on. Therefore, a long-term follow-up is necessary to monitor the patient’s prognosis.Ī 55-year-old woman presented with decreased visual acuity (VA) in the left eye accompanied by periocular pain lasting for 2 weeks. Although the patient had a considerable reaction, steroid therapy could not make MOG-IgG seronegative, instead, the antibody may persist even during remission and flare-ups can recur after steroid withdrawal. In adults, it commonly presents as ON and myelitis. Seropositive MOG-IgG, even at a lower level, could lead to an autoimmune inflammatory demyelination. ![]() The woman’s condition improved by steroid therapy without relapse. So, the clinical diagnose was “possible MOG-IgG-associated encephalomyelitis”. Considering the lower concentration, we retested serum MOG-IgG after 6 months of steroid therapy, using cell-based assay, then we still got the same result which was also barely above the negative cut-off value. AQP4-IgG was tested seronegative, while the MOG-IgG was positive, titer 1:10, by indirect immunofluorescence. MRI showed a left optic nerve demyelination image and a T2 hyperintensity at C7 vertebral segment without any extra specific lesions. Case presentationĪ 55-year-old Chinese woman presented with acute optic neuritis manifestations in the left eye. ![]() Whether it is significant that a seropositive lower titer level for MOG-IgG could cause disease is still unknown. The diagnosis of immunoglobulin G serum antibodies to myelin oligodendrocyte glycoprotein (MOG-IgG) associated inflammatory demyelinating disorders can be confirmed by the presence of MOG-IgG, yet its general cut-off concentration had not yet to be defined. ![]()
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