MOG Antibody-Associated Bilateral Optic Neuritis Associated with Johnson and Johnson COVID-19 Vaccination (P12-3.009)

Abstract

<h3>Objective:</h3> To describe a case of bilateral optic neuritis associated with MOG Antibodies following vaccination with Johnson and Johnson (J&amp;J) COVID-19 vaccine. <h3>Background:</h3> Cases of MOG Antibody Disease (MOGAD) following infection or vaccination have been reported, including in association with both COVID-19 infection and vaccination. However, no cases have been reported in Africa, associated with the J&amp;J vaccine or presenting with bilateral optic neuritis. <h3>Design/Methods:</h3> NA <h3>Results:</h3> A 37-year-old Zambian woman presented two weeks after vaccination with the J &amp; J COVID-19 vaccine with progressive vision loss and headache associated with eye movement. Loss of color vision developed a week later and progressed over four days to complete blindness. On examination, she had no light perception in both eyes, dilated pupils with sluggish light reflex, and bilateral papilledema. The remainder of her examination was normal. Baseline investigations were unremarkable, and MRI and MRV of the brain were normal. Orbital MRI was not available in our setting. OCT showed bilateral thickening of the retinal nerve fiber layer with nasal depression of the macular ganglion cell inner plexiform layer. Serum aquaporin-4 antibodies were negative, and serum MOG antibodies were positive. The patient received a 5-day course of pulse-dose steroids followed by 1mg/kg oral prednisolone tapered over 8 weeks. She experienced full recovery of her visual acuity within 10 days of pulse-dose steroids and remained relapse free for six months. <h3>Conclusions:</h3> This case of MOG-antibody associated bilateral optic neuritis triggered by J&amp;J COVID-19 vaccine in a Zambian woman is unique in that the diagnosis was made in a resource limited setting, necessitating a high index of suspicion, reliance on clinical skills and highly targeted testing. This case further highlights the need for surveillance for similar cases and it adds literature of cases of MOGAD associated with various COVID-19 vaccines. <b>Disclosure:</b> Dr. Mutete has nothing to disclose. NALUCA MWENDAWELI has nothing to disclose. Dr. Asukile has nothing to disclose. Dr. Serenje has received research support from Orbis International. Willard Mumbi has nothing to disclose. The institution of Dr. Saylor has received research support from National Institutes of Health. The institution of Dr. Saylor has received research support from National Multiple Sclerosis Society. The institution of Dr. Saylor has received research support from American Academy of Neurology. The institution of Dr. Saylor has received research support from United States Department of State. Dr. Saylor has a non-compensated relationship as a Member of multiple committees and task forces focused on improving access to MS medications to people across the world with Multiple Sclerosis International Federation that is relevant to AAN interests or activities. Dr. Saylor has a non-compensated relationship as a Member of the Neurology and COVID19 committee with World Health Organization that is relevant to AAN interests or activities. Dr. Saylor has a non-compensated relationship as a Member of the International Outreach Committee, Junior and Early Career Membership Committee, and Educational Innovation Commitees with American Neurological Association that is relevant to AAN interests or activities.