Will NMOSD make me lose my vision again?

Question

Hello doctor,

I am 33 and recently diagnosed with NMOSD after an MRI showed optic nerve inflammation and spinal cord lesions. My AQP4 antibody came back positive. I had blurry vision and numbness in my legs, and now I am on steroids plus Rituximab infusions. I am still learning about this.

Can you explain in plain language how NMOSD is different from MS, and whether this means I will keep having relapses?
Also, are there things I should avoid, like vaccines, heat, or stress? I am terrified of losing my eyesight again.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query.

I understand how scary this diagnosis can feel, especially with vision problems and numbness in your legs. Anyone in your position would feel worried. The good thing is that you sought medical help early, and treatment has already started, which is very important in this condition.

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune disease. This means the immune system mistakenly attacks parts of the nervous system, mainly the optic nerves (affecting vision) and the spinal cord (causing symptoms like numbness or weakness in the legs).

Your positive Aquaporin-4 antibody test (detects NMO-IgG antibodies in blood or cerebrospinal fluid) strongly supports this diagnosis and helps distinguish NMOSD from conditions like multiple sclerosis (a chronic, autoimmune disease where the immune system destroys the protective myelin sheath around nerves in the brain and spinal cord).

Most of the important investigations have already been done. The MRI likely showed inflammation in the optic nerve or spinal cord, which explains your symptoms. Doctors may continue routine blood tests while you are on Rituximab to monitor blood counts and organ function.

The treatment you mentioned is appropriate. Steroids help control the current inflammation, while Rituximab helps prevent future attacks. NMOSD usually happens in relapses, so the main goal of treatment is to stop new attacks from occurring. With proper treatment, many people remain stable for long periods.

Rituximab is usually given as an infusion at regular intervals (often around every six months). Keeping up with these treatments and follow-ups is very important.

Here are a few ways that can also help:

Avoid live vaccines while on Rituximab unless your doctor advises otherwise.
Get enough sleep and manage stress.
Try to avoid extreme heat or overheating.
Stay hydrated and maintain a healthy routine.
Report any new symptoms early, even mild vision changes or tingling.

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.