• Chio Kogure, Wataru Kikushima, Yoshiko Fukuda, Yuka Hasebe, Toshiyuki Takahashi, Takashi Shibuya, Yoichi Sakurada, and Kenji Kashiwagi.
• Department of Ophthalmology, University of Yamanashi, Chuo, Yamanashi.
• Medicine (Baltimore). 2021 May 14; 100 (19): e25865.

RationaleCoronavirus disease 2019 (COVID-19) has spread worldwide. It involves multiple organs of infected individuals and encompasses diverse clinical manifestations. We report a case of acute optic neuritis (ON) associated with myelin oligodendrocyte glycoprotein (MOG) antibody possibly induced by COVID-19.Patient ConcernsA 47-year-old man presented to our clinic with left eye pain and vision loss. Magnetic resonance imaging of the orbit revealed the bilateral high intensity of the optic nerve sheaths. He tested positive for COVID-19 by polymerase chain reaction (PCR) testing on the day of admission but he had no signs of respiratory illness. Laboratory testing revealed that MOG immunoglobulin G (MOG IgG) was positive, but other antibodies including aquaporin-4 were negative.DiagnosisThe patient was diagnosed with MOG antibody-positive acute ON possibly induced by COVID-19.InterventionsSteroid pulse therapy consisting of methylprednisolone 1 g/day for a total of 3 days, followed by an oral prednisolone taper was performed.OutcomesHis left eye pain was immediately relieved, and his decimal vision improved from 0.03 to 0.1 on the day of discharge. Outpatient follow-up 2 weeks later revealed left a decimal vision of 1.2, and a complete resolution of the left eye pain.LessonsOur case indicated that COVID-19 might trigger an autoimmune response that leads to MOG antibody-associated ON, similar to other pathogens that were reported in the past. The treatment response to steroid pulse therapy was preferable following a typical course of MOG antibody-positive ON.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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