Optic neuromyelitis optica Optic neuromyelitis optica is another autoimmune disease of the central nervous system that primarily involves the optic nerve and spinal cord, and rarely the brain. It was once thought to be a variant of multiple sclerosis. Twenty years ago, scholars at the Mayo Clinic in the United States found that the two were very different from clinical comparisons. eight years ago, scholars there identified antibodies to aquaporin 4 from patients’ sera, thereby establishing that optic neuromyelitis optica is another disease independent of multiple sclerosis. Asians, Africans, and South Americans, including our country, show a high incidence. Clinical manifestations Optic neuritis, inflammatory changes of optic neuritis, patients may have decreased vision, blurred vision, visual field defects, and changes in visual color. Painful eye movements. Myelitis, motor and sensory deficits and abnormal sphincter function under the plane of damage. Patients often have numbness and pain in the hands and feet, sensory hypersensitivity, and a sensation of binding in the thoracolumbar region. Patients with cervical spinal cord lesions may experience respiratory distress. Diagnosis A definitive diagnosis of optic neuromyelitis optica requires a physician based on the patient’s medical history, clinical presentation and a complete neurological physical examination, such as gait during walking, muscle strength, tendon reflexes, and sensation. In addition, ancillary tests include: 1. MRI to determine the presence, number, and size of lesions in the optic nerve, spinal cord, or brain. 2. Serum tests to determine the presence of anti-water channel protein-4 antibodies and other autoantibodies, such as antinuclear antibodies and antibodies, to help rule out other autoimmune diseases. 3.Lumbar puncture examination, through which the doctor determines the presence of immunoreactive cells, proteins, and antibodies in the patient’s cerebrospinal fluid in order to assist the doctor in differentiating the diagnosis of optic neuromyelitis optica or multiple sclerosis. 4. Evoked potential examination, in which the technician places receiving electrodes on the patient’s scalp and stimulating electrodes on the external ear, neck, shoulder, and back to establish whether the patient has lesions of the brain, spinal cord, and optic nerve through the brain’s response to external sound, light, and touch. Treatment of optic neuromyelitis optica In the acute phase, which has similarities to multiple sclerosis, treatment is aimed at controlling the progression of the disease. Hormonal therapy is preferred. If hormonal therapy is not effective, immunoglobulin or plasma exchange may be used. In the remission phase, hormone therapy combined with immunosuppressive therapy is often required. Prognosis Although there is an overlap between the clinical manifestations of optic neuromyelitis optica and multiple sclerosis, the prognosis is poor: within 5 years, 50% of patients are left with permanent neurological disability, including blindness (in one or both eyes) and paralysis (in the lower extremities or quadriplegia). Therefore, it is crucial to obtain the correct diagnosis and treatment early. We have accumulated rich clinical experience in the diagnosis and treatment of neuroimmune diseases, especially for inflammatory demyelinating diseases, based on our experience in the treatment of tumors, organ transplants, and rheumatic diseases at home and abroad, and have concluded sequential and combined treatment programs adapted to different genders and age stages. As a result, most of the patients treated have benefited, and getting married and having children, returning to work, and completely getting rid of drug treatment are no longer the patients’ extravagant hopes.