Effectiveness of Plasma Exchange in Treating With Severe Acute AQP4-Ab Positive Optic Neuritis

Treatment tested

• Corticosteroid & Plasma exchange

Compared with

• Corticosteroid

Other measures (4)

Inclusion Criteria: 1. Age between 18 to 70 years old 2. Serum AQP4-IgG positive optic neuritis 3. Patients must have their VA less than 20/200 4. Course of disease is less than 1 month 5. Patients must provide written informed consent Exclusion Criteria: 1. Females who are pregnancy 2. Patients who are severely allergic to plasma or albumin 3. Patients who have systemic disease and can not accept PE 4. Patients with a tendency to thrombus

Patients aged between 18 and 70 with acute aquaporin-4 immunoglobulin G antibodies (AQP4-IgG) positive optic neuritis, irrespective of prior using of corticosteroids in this episode of disease, are chosen by the physician. Patients will then be randomized to receive high dose of intravenous corticosteroids combined with plasma exchange (PE), or merely high dose of intravenous corticosteroids followed subsequent taper. The main outcome of visual acuity and OCT parameters will be compared at baseline, one, three and six months after treatments, and other assessments will also be recorded and compared. This will allow for determination on whether additional PE plays a role in better prognosis in acute AQP4-IgG positive optic neuritis.