Do you recommend surveillance MRI for patients with MOGAD?

I do not recommend regular surveillance MRI for all patients. It really depends on the case as some MOGAD patients are very stable and don't even require treatment, whereas others can be quite aggressive and resistant to all treatments. The field is still emerging and our understanding of silent disease with MOGAD is poor. Emerging is the serum biomarker neurofilament light chain, which appears quite sensitive, picking up new MOGAD activity and is a lot easier and cheaper than repeated MRI scans...

Silent lesions in MOGAD are quite unusual (<6% per one source). Therefore, there is little utility to routine MRI surveillance in patients with MOGAD.