Department of Neurology (BKC, ML), Massachusetts General Hospital, Harvard Medical School, Boston Massachusetts; and Department of Ophthalmology (BKC), Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts.
J Neuroophthalmol. 2022 Sep 1;42(3):292-296. doi: 10.1097/WNO.0000000000001684.
Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) is an important etiology of neurologic morbidity and specifically, atypical, and relapsing optic neuritis. This review summarizes acute treatment and long-term prevention approaches in MOGAD.
PubMed and Google Scholar databases were manually searched and reviewed.
We review the evidence base for acute treatment of MOGAD with corticosteroids and adjunct therapies, such as intravenous immunoglobulin (IVIg) and plasma exchange. We discuss the utility of prolonged corticosteroid tapering after the acute attack. We then summarize the commonly used disease-modifying treatments for relapsing MOGAD, including chronic low-dose corticosteroids, classic antirheumatic immune suppressants, biologic agents, and IVIg.
While acute MOGAD attacks are usually treated with high-dose IV corticosteroids, longer oral corticosteroid tapers may prevent rapid relapse. Multiple long-term treatment strategies are being employed in recurrent MOGAD, with IVIg is emerging as probably the most effective therapy.
髓鞘少突胶质细胞糖蛋白抗体病（MOGAD）是神经系统发病率的一个重要病因，特别是非典型和复发性视神经炎。本篇综述总结了 MOGAD 的急性治疗和长期预防方法。
手动检索和综述了 PubMed 和谷歌学术数据库。
我们回顾了 MOGAD 急性治疗中使用皮质类固醇和辅助治疗（如静脉注射免疫球蛋白[IVIg]和血浆置换）的证据基础。我们讨论了急性发作后延长皮质类固醇逐渐减量的效果。然后，我们总结了复发性 MOGAD 常用的疾病修正治疗方法，包括慢性低剂量皮质类固醇、经典抗风湿免疫抑制剂、生物制剂和 IVIg。
虽然急性 MOGAD 发作通常采用大剂量 IV 皮质类固醇治疗，但较长时间的口服皮质类固醇逐渐减量可能预防快速复发。在复发性 MOGAD 中采用了多种长期治疗策略，IVIg 作为可能最有效的治疗方法正在出现。
