Should most patients with optic neuritis be tested for neuromyelitis optica antibodies and should this affect their treatment?

摘要

The management of NMO remains controversial, primarily because there are no large scale studies similar to those for multiple sclerosis (MS) that dictate the best practice standards. For the neuroophthalmologist, recognition of the earliest manifestations of NMO is critical because the condition may subsequendy produce bilateral and severe visual loss. Furthermore, the patient with NMO is at risk of significant disability by virtue of a longitudinally extensive myelitis. Unfortunately, the diagnosis of benign disease in NMO can only be made in retrospect and requires a very long observation period. Therefore, I would treat the patient who develops unilateral optic neuritis who has a positive NMO titer. The stakes for watchful waiting are too high.