CASE REPORT article
Front. Ophthalmol.
Sec. Neuro-Ophthalmology Disorders
Volume 5 - 2025 | doi: 10.3389/fopht.2025.1620614
This article is part of the Research TopicOptic Neuropathies: Etiologies, Diagnosis, and TreatmentsView all 10 articles
Fundus Findings in Myelin Oligodendrocyte Glycoprotein Associated Optic Neuritis: A Case of Retinal Hemorrhages and Roth Spots
Provisionally accepted
- Washington University in St. Louis, St. Louis, United States
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Myelin oligodendrocyte glycoprotein-associated optic neuritis is a sight-threatening demyelinating disorder that can present with various ocular manifestations. Here, we describe a unique case of bilateral myelin oligodendrocyte glycoprotein-associated optic neuritis with unilateral retinal hemorrhages and Roth spots.We present the case of a 48-year-old male with acute-onset painful, severe vision loss in both eyes. Initial fundoscopic examination revealed bilateral optic nerve edema with unilateral retinal hemorrhages and Roth spots. Imaging was notable for perineural enhancement along both optic nerves. Serological testing revealed elevated myelin oligodendrocyte glycoprotein antibodies. The patient was treated with high-dose intravenous steroids followed by plasmapheresis, resulting in substantial clinical improvement.We conducted a literature review of all available studies published before March 30, 2025, using PubMed, including the keywords "myelin oligodendrocyte glycoprotein associated optic neuritis," "myelin oligodendrocyte glycoprotein," "optic neuritis," "Roth spots," and "retinal hemorrhage." We found that this is the first reported case in a male patient-and only the third reported case overall-of retinal hemorrhages and Roth spots occurring in the context of myelin oligodendrocyte glycoprotein-associated optic neuritis. While retinal hemorrhage and Roth spots have not historically been associated with myelin oligodendrocyte glycoprotein-associated optic neuritis, recognizing the spectrum of fundoscopic findings is crucial for early diagnosis and management of this potentially sight-threatening disease.
Keywords: Myelin Oligodendrocyte Glycoprotein Associated Optic Neuritis, MOGAD, Roth spots, Retinal Hemorrhage, atypical optic neuritis, peripapillary hemorrhage, acute vision loss
Received: 29 Apr 2025; Accepted: 18 Aug 2025.
Copyright: © 2025 Wilson, Cummings, Elitt and Van Stavern. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: John Ralph Wilson, Washington University in St. Louis, St. Louis, United States
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