NEURO-OPHTHALMOLOGY: Edited by Heather E. MossClinical phenotype, radiological features, and treatment of myelin oligodendrocyte glycoprotein-immunoglobulin G (MOG-IgG) optic neuritisChen, John J.a,b; Bhatti, M. Tariqa,b Author Information aDepartments of Ophthalmology bDepartments of Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA Correspondence to John J. Chen, MD, PhD, Department of Ophthalmology, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA. Tel: +1 507 284 4946; fax: +1 507 284 4612; e-mail: [email protected] Current Opinion in Neurology 33(1):p 47-54, February 2020. | DOI: 10.1097/WCO.0000000000000766 Buy Metrics Abstract Purpose of review To review the clinical characteristics, radiological manifestations and treatment of myelin oligodendrocyte glycoprotein (MOG)-immunoglobulin G (IgG) optic neuritis. Recent findings Serum antibodies to MOG have recently been found to be a biomarker of MOG-IgG-associated disorder (MOGAD), a demyelinating disease distinct from both multiple sclerosis (MS) and aquaporin-4-IgG neuromyelitis optica spectrum disorder (AQP4-IgG-positive NMOSD). The phenotype of MOGAD is broad and includes optic neuritis, transverse myelitis, and acute demyelinating encephalomyelitis (ADEM). Optic neuritis is the most common presentation in adults, whereas ADEM is the most common presentation in children. Clinical characteristics suggestive of MOG-IgG optic neuritis include recurrent optic neuritis, prominent disc edema, and perineural enhancement of the optic nerve on magnetic resonance imaging. Although the nadir of vision loss is severe with MOG-IgG optic neuritis, the recovery is typically better than AQP4-IgG optic neuritis and therefore has a favorable overall prognosis. Patients with relapsing disease will often need chronic immunotherapy. Rituximab, azathioprine, mycophenolate mofetil, and monthly intravenous immune globulin are the most commonly utilized treatments. Summary MOGAD is a unique entity that is separate from both MS and AQP4-IgG-positive NMOSD. Recognition of the clinical and radiologic features allow for the correct diagnosis. Future randomized trials will determine the optimal treatment for MOGAD. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.