A Case Report of Myelin Oligodendrocyte Glycoprotein Antibody–Associated Optic Neuritis with Macular Serous Retinal Detachment Showing Initial Spontaneous Improvement

Introduction

High-dose steroids are commonly used for the acute treatment of myelin oligodendrocyte glycoprotein antibody-associated optic neuritis (MOG-ON). Macular serous retinal detachment (SRD) is rare in MOG-ON, with only three cases reported to date. However, in all of these reports, steroid treatment was administered in the acute phase after diagnosis, and no previous reports have examined the natural course of MOG-ON with SRD or the need for therapeutic intervention. Case Presentation: A woman in her 60s presented with decreased visual acuity in her left eye and was found to have optic disc swelling and macular SRD in the same eye. Despite severe anatomical findings, spontaneous improvement was observed. MOG-ON was diagnosed based on low-titer serum MOG-IgG positivity, contrast enhancement of a long segment of the left optic nerve on magnetic resonance imaging (MRI), and exclusion of other diseases. Intravenous methylprednisolone (1 g daily for 3 days) was administered for residual scotoma, resulting in further functional improvement. No recurrence was observed during 6 months of follow-up.