How to protect vision in NMOSD with recurrent optic neuritis?

Question

Hello doctor,

I am a 41-year-old female. Today, I went to the bathroom and noticed a small, jelly-like substance that appeared to contain some blood, but I was not certain. I have had multiple bowel movements today. During my third trip to the bathroom, my stool was a normal color; however, when I wiped, I noticed blood along with a jelly-like mucus.

I occasionally experience bleeding after wiping. Just now, I felt the urge to go again, but I only passed urine. I also noticed this substance coming from my bowels. I will attach a picture for reference. I would appreciate your response.

Please guide me.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I would like to request a more detailed medical history, particularly regarding whether you were taking any immunosuppressive drugs after your first attack. Additionally, what was your baseline visual acuity following that first attack?

If your visual acuity has not returned to baseline after the second attack and it has been less than a month since that second attack, a trial of intravenous immunoglobulin or plasmapheresis should be conducted as part of acute therapy.

There are many immunosuppressive drugs available, including Inebilizumab and Eculizumab. These should be initiated based on availability in your country and your insurance coverage. It is recommended that you undergo immunosuppressive therapy to prevent future attacks.

Repeating the neuromyelitis optica spectrum disorder (NMOSD) titer is not particularly significant at this time for assessing your treatment response. Supplements like vitamin B12 can be taken in high doses, especially if you have a coexisting deficiency.

I hope you find this information helpful.

Thank you for reaching out.