MOG antibody disease (MOGAD) has therefore emerged as a separate disease entity with a distinct pathogenesis from classic NMOSD.5,6 The relevance of magnetic resonance imaging (MRI) in NMOSD has been clearly established for diagnosis, but not for long-term monitoring, in contrast to MS, for which MRI is routinely employed to monitor disease activity and treatment response.7 This may stem from the traditional view that long-term disability in NMOSD arises only from clinical relapses, and thus routine imaging is unlikely to change management. This evidence concerns the gene MOG and myeloid sarcoma.