Dr.Madhuri Gadde, M20885
Neuromyelitis optica spectrum disorders(NMOSD) are a group of autoimmune conditions characterized by inflammatory involvement of the optic nerve, spinal cord and central nervous system. A 23 year old female presented with bilateral acute painless diminution of vision since 10 days following headache. She denied perception of light with dilated sluggish pupils and pallid disc edema in both eyes. Optical coherence tomography of the disc showed increased RNFL thickness with hypo reflective subretinal spaces. VEP showed prolonged P100 latency. MRI brain was suggestive of bilateral optic neuritis. CSF analysis for oligoclonal bands and NMO antibody IgG was negative. The condition was diagnosed as NMOSD. No visual improvement noted with IV methylprednisolone. Plasmapheresis initiated, vision improved to CF4m. This case highlights the importance of plasmapheresis in NMOSD cases resistant to steroids. Early initiation of plasmapheresis may improve the chances of visual recovery in such cases.
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