Neuromyelitis Optica (Devic's Disease)

PATHOLOGIC FEATURES The optic nerves received special attention from the early investigators of neuromyelitis optica. These writers stated that the pathologic condition of the spinal cord was an ordinary acute myelitis and that the involvement of the optic nerves represented an extraordinary pathologic phenomenon. The loss of myelin sheaths in the optic nerves was first recorded by Achard and Guinon, 6 who described almost complete disappearance of myelin in the optic nerves of their patient. Elschnig 11j verified their observations in his case and described intraocular lesions; he noted extreme thinning of the nerve fiber layer of the retina, with diminution of the ganglion cells. Dalen 11q reported the same alterations in the retinas of another patient with this disease. Dreschfeld 11l wrote an excellent pathologic report of a case, in which he described perivascular infiltration and irregularly distributed patches of demyelination throughout the lesions. The centers of the optic