In this context another important differential for LHON is represented by Neuromyelitis Optica Spectrum Disorder-optic neuritis and MOG antibody-associated disease (MOGAD)-optic neuritis in which the more frequent bilateral involvement, and the usual more severe visual outcome and severity of optic atrophy make the differential diagnosis more difficult than for the classical Multiple Sclerosis-related optic neuritis (45). The gene discussed is MOG; the disease is Leber hereditary optic neuropathy.