Supplementary Material for: Central Retinal Artery Occlusion Associated with Myelin Oligodendrocyte Glycoprotein Antibody Disease: A Case Report

Introduction: Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) is a more recently characterized neuroinflammatory condition which has been implicated with optic neuritis (ON). While the potential causes of central retinal artery occlusion (CRAO) are several, neuroinflammatory causes should not be excluded from the differential diagnosis. Our unusual case presents a patient with prior history of MOGAD-ON and venous stasis retinopathy in their right eye, who in their current presentation, developed a CRAO in their left eye.
Case Presentation: A 43-year-old female with a history of concurrent venous stasis retinopathy and MOGAD-ON (diagnosed six years prior and managed with long-term immunosuppression and oral steroids) in her right eye presented with a five-hour history of pain and blurry vision in her left eye. Examination of the left eye revealed a visual acuity (VA) of 20/80, a cherry red spot (without a visualized embolus), and a new generalized visual field defect. Ocular coherence tomography (OCT) revealed diffuse retinal edema in her left eye with multiple layers of retinal thinning. She was referred to stroke neurology and continued oral steroid therapy. At six-month follow-up, her VA had markedly improved to 20/30 in her left eye, and she had stable OCT parameters.
Conclusion: This unique case demonstrates sequential venous stasis retinopathy and central retinal artery occlusion in opposite eyes, which were notable for their association with recurrent MOGAD-ON. Further research is needed to better elucidate the role of MOGAD in vascular occlusive events and whether this relationship may be arteritic in etiology.

引言：髓鞘少突胶质细胞糖蛋白抗体相关疾病（Myelin oligodendrocyte glycoprotein antibody disease, MOGAD）是近年被明确的神经炎症性疾病，与视神经炎（optic neuritis, ON）存在关联。尽管视网膜中央动脉阻塞（central retinal artery occlusion, CRAO）存在多种潜在病因，鉴别诊断不应排除神经炎症性因素。本罕见病例患者既往有右眼MOGAD相关性视神经炎及静脉淤滞性视网膜病变病史，本次就诊时出现左眼视网膜中央动脉阻塞。

病例报告：一名43岁女性患者，6年前确诊右眼同时存在静脉淤滞性视网膜病变与MOGAD相关性视神经炎，予长期免疫抑制治疗与口服糖皮质激素管理，本次因左眼疼痛、视物模糊5小时就诊。左眼检查显示视力（visual acuity, VA）为20/80，可见樱桃红斑（未查见栓子），并存在新发全视野视野缺损。光学相干断层扫描（OCT）显示左眼弥漫性视网膜水肿，伴多层视网膜变薄。患者被转诊至卒中神经内科，继续口服糖皮质激素治疗。6个月随访时，左眼视力显著改善至20/30，OCT参数保持稳定。

结论：本独特病例呈现双侧眼先后发生静脉淤滞性视网膜病变与视网膜中央动脉阻塞的特殊表现，其与复发性MOGAD相关性视神经炎存在显著关联。未来需开展进一步研究，以阐明MOGAD在血管阻塞性事件中的作用，以及该关联是否存在动脉炎相关的病因学机制。