# Bilateral myelin oligodendrocyte glycoprotein antibody-associated disease after cataract surgery

## TL;DR

A woman developed a rare neurological condition affecting her optic nerves shortly after cataract surgery.

## Contribution

This case highlights an unusual onset of MOGAD following cataract surgery, expanding clinical understanding of its triggers.

## Key findings

- Bilateral optic neuritis occurred five days after cataract surgery in a 67-year-old woman.
- MOGAD IgG autoantibodies were detected at a high titer, confirming the diagnosis.
- MRI showed bilateral optic perineuritis, while CSF analysis was normal.

## Abstract

To report an unusual presentation of bilateral myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) associated with optic neuritis occurring during the early post-operative cataract surgical period.

This was an observational case report.

A 67-year-old Caucasian female presented with right eye visual acuity decrease occurring five days after bilateral cataract surgery. She also reported moderate pain associated with eye movements. While no inflammation could be observed, bilateral optic disc edema was observed on fundus examinations. Fluorescein angiography showed leakage of dye at late phases at the optic nerves, with no retinal vasculitis or choroidal ischemia on either eye. Orbit and brain magnetic resonance imaging showed bilateral optic perineuritis. Cerebrospinal fluid analysis was normal, as was the opening pressure (<25 cm of water) measured during lumbar puncture. Blood testing revealed MOGAD Immunoglobulin G (IgG) autoantibodies at a titer >1:100.

This report describes an atypical presentation of MOGAD associated with bilateral optic neuritis occurring a few days after cataract surgery.