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Editorial
January 1, 2008

Is Neuromyelitis Optica Eyeing a Distinct Path From Multiple Sclerosis?

Arch Ophthalmol. 2008;126(1):128-129. doi:10.1001/archophthalmol.2007.3

Devic1 originally defined neuromyelitis optica (NMO) in the late 19th century as an acute monophasic syndrome characterized by bilateral (or rapidly sequential) optic neuritis and severe myelitis; attacks were limited to the optic nerve and spinal cord and resulted in significant disability. Subsequently, variations in clinical presentation, frequency of relapses, and degree of severity have been reported.27 Since 1999, 2 versions of standardized clinical criteria for the diagnosis of NMO have been suggested,8,9 and further revisions are likely in the near future. Given the lack of precisely defined clinical and diagnostic features, controversy has emerged regarding the potential relationship of NMO with other inflammatory conditions of the central nervous system, most notably multiple sclerosis (MS). The need to clearly distinguish between these conditions at the time of diagnosis, however, may be critical, given the perceived deleterious effect of NMO on neurologic function and the differences in treatment strategies aimed at limiting catastrophic consequences, such as bilateral vision loss and impaired motor function.6,10

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