Neurological manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are relatively common. Although some may be consequences of direct cellular viral invasion (neurotropism), many represent post-infectious inflammation mediated by autoimmune mechanisms. We herein report the case of a 69-year-old diabetic male who presented with bilateral sub-acute, progressive loss of vision 45 days after suffering a presumed SARS-CoV-2 related pneumonia. He had bilateral optic disc oedema. Magnetic resonance imaging showed uniform contrast enhancement of both optic nerves without spinal cord involvement. He tested positive for SARS-CoV-2 IgG and myelin oligodendrocyte glycoprotein (MOG) IgG antibodies. He was treated with intravenous methylprednisolone for 5 days. The optic disc oedema resolved within 6 weeks with improvement in visual acuity, although optic atrophy developed by week 16. The MOG-IgG antibody test turned negative after 24 weeks.
Keywords: COVID-19; SARS-CoV-2; myelin oligodendrocyte glycoprotein (MOG); optic neuritis.
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