{
  "abstract": "Myelin oligodendrocyte glycoprotein-antibody disease (MOGAD) is an immune-mediated demyelinating disorder, distinct from MS, which typically affects the optic nerve, spinal cord, brain and/or brainstem. Diffuse white matter involvement that resembles a leukodystrophy has been reported only in children. We present a woman aged 29 years with new right optic neuritis on a background of previously unexplained, longstanding, bilateral, reduced visual acuity. MR scan of the brain and orbits showed confluent, bilateral, posterior predominant white matter changes reminiscent of a leukodystrophy, along with bilateral optic atrophy. She was strongly MOG-seropositive. Positron-emission tomography scanning showed enlarged cervical lymph nodes, and biopsy found necrotising granulomata without tuberculosis. She showed a marked clinico-radiological response to corticosteroids, going from legally blind to functioning independently. Most strikingly, the chronically affected left eye improved significantly, 5 years after symptom onset. This expands the phenotypic spectrum of MOGAD as well as therapeutic expectations after a delayed presentation.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurology, Imperial College Healthcare NHS Trust, London, England, UK"
      ],
      "name": "Viveka Biswas"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Imperial College Healthcare NHS Trust, London, England, UK"
      ],
      "name": "Laura Martin"
    },
    {
      "affiliations": [
        "Department of Neuroradiology, Imperial College Healthcare NHS Trust, London, England, UK"
      ],
      "name": "Emma A Lim"
    },
    {
      "affiliations": [
        "Department of Neuroradiology, Imperial College Healthcare NHS Trust, London, England, UK"
      ],
      "name": "Luke Dixon"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Imperial College Healthcare NHS Trust, London, England, UK"
      ],
      "name": "Onn Min Kon"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Imperial College Healthcare NHS Trust, London, England, UK"
      ],
      "name": "James Millard"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Imperial College Healthcare NHS Trust, London, England, UK"
      ],
      "name": "Maddalena Cerrone"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Imperial College Healthcare NHS Trust, London, England, UK"
      ],
      "name": "Anna Dawson"
    },
    {
      "affiliations": [
        "Department of Neurology, Imperial College Healthcare NHS Trust, London, England, UK"
      ],
      "name": "Richard Nicholas"
    },
    {
      "affiliations": [
        "Department of Neurology, Imperial College Healthcare NHS Trust, London, England, UK"
      ],
      "name": "Antonio Scalfari"
    },
    {
      "affiliations": [
        "Department of Neurology, Imperial College Healthcare NHS Trust, London, England, UK"
      ],
      "name": "James A Varley"
    }
  ],
  "title": "Myelin oligodendrocyte glycoprotein-antibody disease (MOGAD) with leukodystrophy-like presentation",
  "uid": "4233d0be-01ff-5465-a16e-13f3d0817104"
}