GCA is a common vasculitis in people older than 50 and can cause permanent vision loss. On the other hand, MOG antibody disease (MOGAD) can also cause vision loss through the development of MOG antibodies that target myelin sheaths in the CNS. GCA and MOGAD are considered separate disease processes. GCA with the presence of anti-MOG antibodies has not been published in any case reports. This is the first case documenting GCA with the atypical presence of anti-MOG antibodies. 

Visual acuity right eye (OD) 20/400 and left eye (OS) 20/25, right  RAPD and . inferior altitudinal defect and central scotoma with pain on eye movement. Fundus exam showed optic nerve head edema with diffuse trace pallor and multiple cotton wool spots. Labs showed ESR of 26mm/hr, CRP of <0.50mg/dL, ANA titers 1:160. MOG AB serum positive titer 1:40, MOG Mayo Clinic CSF Panel positive with titers 1:100. Remaining CSF studies were negative. MRI Brain/Face/Orbit showed thickening and enhancement of the right optic nerve with head bulging. Right temporal artery biopsy showed intimal hyperplasia and loss of the internal elastic lamina, confirming features of GCA.

With steroid treatment, the patient's vision improved. However, the unique concurrent presence of GCA and anti MOG is worth further examination. There are no existing studies to suggest an association between GCA and anti-MOG, making it difficult to ascertain whether anti-MOG contributed to the development of GCA or vice versa, or if these two conditions are separate entities and treated individually.