DR. AYUSHI CHOUDHARY

Dr.Reshma Ramakrishnan

Abstract

Neuromyelitis optica(NMO) rare autoimmune disease of nerves of eyes & CNS. 8yr girl with sudden painless DOV in BE from 4 days.BCVA was HMCF, accurate projections of rays in BE. Anterior segment-B/L 6mm pupils, sluggishly RTL. Rest normal. Fundus- B/L disc oedema, blurring of all margins in BE. MRI-nodular & gyral enhancement showing demyelinating disease. CSF & ANA profile-normal. Aquaporin-4 serum antibodies-negative, Myelin Oligodendrocyte antibodies-positive. Diagnosis of NMO made.

Started on IV steroids. Day10, BCVA was same in RE, improved to FC 2m in LE. RE fundus-pale, atrophic disc secondary to papillitis, LE-resolution of disc oedema.

NMO presentation varies from transient visual loss to respiratory failure & death. Rapid diagnosis & treatment are essential. Cases of B/L optic neuritis should be evaluated & possibility of NMO ruled out. It’s important to differentiate NMO from Multiple Sclerosis as NMO has more severe morbidity & both have a differing progression & treatment