Myelin Oligodendrocyte Glycoprotein-Associated Optic Neuritis in a Pediatric Patient With Known Leber's Hereditary Optic Neuropathy

Leber's hereditary optic neuropathy (LHON) is a genetic optic neuropathy which can cause sequential, subacute painless vision loss (1, 2). Myelin oligodendrocyte glycoprotein (MOG) associated demyelination (MOG-AD) is known to present as acute disseminated encephalomyelitis and neuromyelitis optica spectrum disorder (3). There has been an association of genetically confirmed LHON with MS-like disease reported, known as Harding syndrome (4), as well as cases of LHON associated with aquaporin-4-IgG (AQP-4) disease (5). MOG-AD is rare, with one reported case in an adult (6), but we are not familiar with this combination having occurred in a child.