DOI: https://doi.org/10.36347/sjams.2025.v13i08.009

Pages: 1589-1593

Background: Neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are distinct autoimmune demyelinating conditions that affect the optic nerves and spinal cord. Regional data from Bangladesh are limited. This study aimed to detect AQP4 and MOG antibodies in patients with clinically suspected NMOSD and compare the demographic, clinical, and neuroimaging features between seropositive groups. Methods: This prospective observational study was conducted at the Neuro-ophthalmology Department of Ispahani Islamia Eye Institute and Hospital, Dhaka, from January 2020 to March 2022. Patients with atypical optic neuritis underwent clinical evaluation, visual acuity assessment, and antibody testing using an immunofluorescence assay. Neuroimaging was performed in selected patients. The data were summarized descriptively. Results: Of the 184 patients, 64 (34.8%) were MOG-positive, 16 (8.7%) were AQP4-positive, and 2 (1.1%) were double seropositive. Female predominance was observed in both groups (65.6% MOG+, 81.2% AQP4+). The median age at onset was 25 years (MOG+) and 28 years (AQP4+). Severe visual loss (<6/60) was the most common presentation in the affected eyes (74.3% MOG+, 76.9% AQP4+). Bilateral papillitis predominated in MOG+ cases, whereas AQP4+ cases showed equal unilateral and bilateral papillitis. MRI revealed spinal cord lesions in 12.5% of AQP4+ cases, but none in MOG+ cases. Conclusion: MOGAD was more frequent than AQP4-positive NMOSD in this Bangladeshi cohort, with both groups presenting severe visual impairment. Routine antibody testing is recommended for atypical optic neuritis to enable accurate diagnosis and appropriate treatment.