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Topics:
Neurology • Neuro-immunology
How do you approach the management of acute attacks of MOGAD-associated optic neuritis?
Specifically, what do you do if there is minimal improvement with IV steroids and/or IVIG?
Answer from: at Academic Institution
If vision loss is severe and has not improved after corticosteroids/IVIG, I would consider plasma exchange (PLEX). Although we do not have controlled studies of PLEX in MOGAD, it is often used for cases of fulminant demyelination in other neuroinflammatory disorders.
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Answer from: at Community Practice
I would likely have PLEX followed by IVIG for maintenance if this is a recurrence.