Visual evoked potential in myelin oligodendrocyte glycoprotein antibody-associated disease

The visual evoked potential (VEP) patterns of optic neuritis are known to often differ between multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) but have been less reported in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). This study aimed to characterize the VEP pattern in MOGAD and evaluate its utility in distinguishing MOGAD from MS and NMOSD. We retrospectively reviewed the clinical manifestations and VEP findings in patients with MS (n = 29), NMOSD (n = 14), and MOGAD (n = 10). In eyes with acute visual impairment, VEP responses were detectable in all eyes with MOGAD but were undetectable in a significant percentage of eyes with MS (27.3%) and NMOSD (42.9%). In addition, VEP abnormalities in eyes without acute visual impairment were rare in MOGAD (23.1%) compared to MS (55.3%) and NMOSD (42.9%). Our results indicated that subclinical VEP abnormalities or undetectable VEP responses were less common in patients with MOGAD compared to patients with MS and NMOSD. VEP testing demonstrates potential diagnostic utility in distinguishing among these conditions.