- Aka: Devic’s disease
- Is monophasic or relapsing-remitting demyelinating CNS disorder
- Although previously thought to be a variant of multiple sclerosis, it is now recognized to be a distinct disease, particularly prevalent in Asian populations.
- Features of optic neuritis include unilateral decrease in visual acuity over, poor discrimination of colors, “red desaturation,” pain worse on eye movement, relative afferent pupillary defect and a central scotoma.
- Diagnostic criteria
- Bilateral optic neuritis
- Transverse myelitis
- 2 of the following
- Spinal cord lesion involving three or more spinal levels (longitudinally extensive transverse myelitis)
- Initially normal MRI brain
- Aquaporin 4 positive serum antibody (positive in 80%)
- Adults are especially likely to develop a pattern more typical of relapsing-remitting MS after an initial episode of neuromyelitis optica.
- Treatment
- Prednisolone
- Plasma exchange
- Recovery from acute optic neuritis usually takes 4-6 weeks.
- Long term treatment is with immunosuppression (e.g. azothiaprine, rituximab).
- Disease modifying drugs used in MS are not used in the treatment of NMO
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