{
  "abstract": "A 60-year-old woman with a history of long-standing mobility difficulties and intermittent upper limb paresthesia presented with acute visual loss in her right eye, accompanied by painful eye movements and periorbital inflammation. Ophthalmological examination revealed papilledema and retinal hemorrhages, raising suspicion for optic neuritis. MRI of the orbits demonstrated hyperintensity and contrast enhancement of the right retrobulbar fat, optic nerve, and posterior sclera, initially suggesting idiopathic orbital inflammation. However, the MRI also revealed multiple white matter hyperintensities, prompting consideration of a broader inflammatory CNS process.Despite the initial clinical picture, the patient‘s rapid response to high-dose corticosteroids and subsequent positive MOG antibody serology confirmed the diagnosis of MOGAD with associated optic neuritis and orbital inflammation. This case underscores the importance of considering MOGAD in patients presenting with orbital inflammation, even when features appear typical of idiopathic disease. Pre-existing neurological symptoms and the presence of white matter lesions on neuroimaging should further raise suspicion for alternative diagnoses. Early recognition of MOGAD is critical, as it often responds well to corticosteroids and, unlike MS or NMOSD, may not require long-term immunosuppression. This case emphasizes the need for vigilance and thorough investigation in atypical presentations of inflammatory eye disease to ensure accurate diagnosis and appropriate management.anete.zieda@gmail.com",
  "authors": [
    {
      "affiliations": [
        "Kent and Canterbury Hospital"
      ],
      "name": "Zieda Anete"
    },
    {
      "affiliations": [
        "Kent and Canterbury Hospital"
      ],
      "name": "Ramos Rita"
    },
    {
      "affiliations": [
        "Kent and Canterbury Hospital"
      ],
      "name": "Myintzu Mya"
    },
    {
      "affiliations": [
        "Kent and Canterbury Hospital"
      ],
      "name": "Naeim Omar"
    },
    {
      "affiliations": [
        "Kent and Canterbury Hospital"
      ],
      "name": "Harikrishnan Sreedharan"
    }
  ],
  "title": "78 MOGAD masquerading as idiopathic orbital inflammation: a diagnostic pitfall",
  "uid": "e5f53ac2-ce2b-5b0d-ad65-794c4eec892d"
}