Neuromyelitis Optica: Malaysia Experience

Ismail Shatriah, Jakiyah Daud, Chua Chui Yin, Wan Hazabbah Wan Hitam

Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

Purpose: To report clinical presentation and outcome of Neuromyelitis Optica (NMO) in Malaysia.

Methods: A retrospective case review of patients with NMO attended Hospital Universiti Sains Malaysia form July 2006 to June 2010.

Results: All four patients were Malay. There were two males and two females. The age ranged from 26 to 40 years. The mean age of onset was 27.5 years for the monophasic group, and 34 years for the relapsing group. Both females had the relapsing type. Three out of four patients had unilateral optic neuritis as their initial presenting event, with only one patient presented as acute myelitis. The diagnosis of NMO was made based on the revised criteria proposed by Wingerchuk et al. All patients were treated with intravenous methylprednisolone during the acute attack. Only 1 patient was started on systemic Azathioprine. One patient with the monophasic type has good visual recovery, whereas the other patient defaulted follow up. Both patients in the relapsing group had poor visual outcome due to optic atrophy.

Conclusions: The clinical presentations of our patients are parallel with other published series. All the patients are young adults, and the monophasic group has an earlier onset compared to the relapsing group. The relapsing group had poor visual outcome due to optic atrophy.