Clinical and ocular manifestation of neuromyelitis optica and multiple sclerosis

Abstract

Objective To investigate the difference of neuromyelitis optica (NMO) and multiple sclerosis (MS) with clinical and ocular manifestation, imaging features, medical effect and results. Methods Collection of 24 (43 eyes) NMO and 40 (68 eyes) MS in-patient cases which were admitted from January, 1998 to December, 2007. Those systemic and ocular symptoms and therapies were analyzed retrospectively. Results NMO and MS were commonly seen in adulthood females. 83.3% (20/24)of the NMO patients initially broke out as optic neuritis (ON) or systemic symptoms simultaneously. Compared with MS, the visual acuity with ON after the first attack drastically deteriorate and characterized by monophasic course or recurrent relapses with concomitant involvement of either unilateral or bilateral eye, and with very poor prognosis. Spinal cord Magnetic resonance imaging (MRI) in NMO were extended over 3 or more consecutive segments, in contrast, MS rarely exceeded one vertebral segments. MRI findings of the brain in NMO were typically normal, but brain lesions had been seen on MRI in some MS patients. Conclusions NMO is commonly initially broke out as ON.ON is characterized by monophasic course or recurrent relapses with concomitant involvement of either unilateral or bilateral. ON can be fulminate and devastating and very poor prognosis. Spinal cord MRI can be extended over 3 or more consecutive segments. NMO may be distinguished from MS. Key words: Neuromyelitis optica; Multiple sclerosis; Optic neuritis; Magnetic resonance imaging