Current Treatment and Management of Neuromyelitis Optica Spectrum Disorder: Areas for Improvement Publisher



S Jahani SHIMA ; N Rezaeimanesh NASIM ; M Owji MAHSA ; M Arab Bafrani MELIKA ; M Mohammadi Lapevandani MAHSA ; A Nasermoghadasi ABDOREZA
Source: Expert Review of Ophthalmology Published:2025

Abstract

Introduction: The severe autoimmune disease known as Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune disease. Areas covered: Events such as the discovery of the existence of aquaporin-4 immunoglobulin G (AQP4-IgG) antibody has enhanced our understanding of the fundamental pathology of NMOSD greatly. An increased range of therapeutic alternatives have been made proposed following these discoveries. There have trials on these treatments and even though some promising findings have been reported, still large, double-blind, randomized clinical trials are needed to validate their efficacy, how safe they are, and patients would tolerate them. Expert opinion: In recent years, various medications have been developed for NMOSD treatment. However, one of the challenges is the lack of availability of these medications in countries with low economic status. Despite the existence of newer medications in developed countries, refractory cases remain a significant challenge for treatment and offer a wide scope for further research. Most new drugs have been studied in seropositive patients, and their effects in seronegative patients are unclear. There is a need to pay more attention to studies in the field of symptom treatment and treatment in special conditions, such as in children, elderly individuals, and during pregnancy among NMOSD cases. © 2025 Elsevier B.V., All rights reserved.