ATYPICAL CASE OF MYELIN OLOGODENDROCYTE GLYCOPROTEIN ANTIBODY–POSITIVE BILATERAL OPTIC NEURITIS

A 62 years old male presented with sudden diminution of vision in his both eyes (right eye more than left eye). Anterior segment examination revealed bilateral immature senile cataract and there was relative afferent pupillary defect (RAPD) grade 3 in the right eye and sluggish reaction in the left eye. Posterior segment examination revealed bilateral disc edema (right>left), bilateral posterior vitreous detachment (PVD) and subretinal uid (SRF) at the macula in the right eye. After thorough investigations, patient was diagnosed as anti-myelin-oligodendrocyte glycoprotein (MOG) antibody positive bilateral atypical optic neuritis (right eye>left eye) with presence of SRF in right eye at the macula without transverse myelitis. Patient was given steroids, but did not show signicant improvement. This case demonstrates a very unique atypical optic neuritis with several diagnostic dilemmas and focuses on strong clinical acumen to manage these cases.