An 81-year-old woman developed painful vision loss to hand motions in the right eye over a several-day period. Dilated fundus examination revealed no acute pathology, but automated perimetry showed a superotemporal visual field defect in the asymptomatic left eye, suggestive of a junctional defect. Magnetic resonance imaging demonstrated enhancement of the right optic nerve extending to its junction with the optic chiasm. The patient's vision failed to improve with intravenous corticosteroids, but demonstrated significant improvement with therapeutic plasma exchange. She was subsequently found to be seropositive for aquaporin-4 autoantibodies, confirming the diagnosis of neuromyelitis optic spectrum disorder.

一名 81 岁的女性在几天内出现右眼手部动作疼痛性视力丧失。散瞳眼底检查未发现急性病变，但自动视野检查显示无症状左眼存在颞上视野缺损，提示存在交界缺损。磁共振成像显示右侧视神经增强，延伸至其与视交叉的交界处。患者的视力未能通过静脉注射皮质类固醇改善，但通过治疗性血浆置换显示出显着改善。随后发现她的水通道蛋白 4 自身抗体呈血清反应阳性，证实了神经脊髓炎视谱障碍的诊断。