27th June 2023

Neuromyelitis Optica Spectrum Disorder

Neuromyelitis Optica Spectrum Disorders (NMOSD) represent a group of inflammatory conditions of the central nervous system characterised by florid demyelination within the optic nerves and spinal cord. Neuromyelitis Optica itself presents with a stepwise deterioration in the context of recurrent attacks of optic neuritis (often bilateral) and transverse myelitis, which can be longitudinally extensive. The diagnosis of NMOSD can be confirmed through the presence of Aquaporin-4 antibodies in the serum, the titres of which correlate closely with disease severity and activity. Acute flares are aggressively treated with high-dose intravenous steroids for three to five days. Multiple disease-modifying therapies are available for NMOSD, including Eculizumab (monoclonal antibody targeting C5) and Inebilizumab (monoclonal antibody targeting CD19).