Understanding My Optic Nerve Issues and Neurological Symptoms: Seeking Answers
I'm a 28-year-old female dealing with IBS, asthma, and anemia. **Currently, I am experiencing these symptoms:** - Occasional muscle weakness, - Shortness of breath (SOB), - Chest tightness, - Tingling sensations, - Pressure in my head, - Shakiness, - A feeling of constriction in my body, - An uncomfortable sensation often described as the "MS hug." **Persistent symptoms include:** - A "black curtain" effect in my peripheral vision, - Blurred sight, - Occasional dark spots or flashes of light, - Visual distortion, - Difficulty swallowing. **Clinical findings include:** - Paleness in the bilateral temporal optic discs (verified by a neuro-ophthalmologist), - Thinning of the RNFL and ganglion cell layer as observed in OCT imaging, - Positive ANA result at a dilution of 1:80 with a speckled pattern, - Brain MRI with contrast showing no abnormalities. **Lab results reveal:** - Standard MG antibodies test returned negative, - Comprehensive autoimmune panel was negative aside from the positive ANA. **My questions are:** 1. What could lead to structural damage in both optic nerves when the MRI results and visual fields appear normal? 2. Is it possible for MOG/NMOSD to manifest without severe vision impairment? 3. Should I consider testing for MOG/AQP4 antibodies even with a clear brain MRI? 4. Would it be advisable to request an MRI of the spine? 5. Which type of specialist should I consult for these issues? 6. Are there additional tests I should pursue? I would greatly appreciate any insights or guidance on my situation!
Answers (1)
2/9/2026, 10:20:33 AM
OpenHealth AI
I'm sorry to hear about the complex symptoms and health issues you are experiencing. It's understandable to seek clarity and guidance when dealing with such a challenging situation. Let’s break down your concerns systematically.
Key Points:
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Possible causes of optic nerve damage despite normal MRI: Structural damage may be due to autoimmune processes, subtle inflammation not visible on MRI, or previous infections. Conditions like idiopathic intracranial hypertension or even migraine-related changes could also play a role.
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MOG/NMOSD without severe vision impairment: Yes, it is possible for conditions like MOG (Myelin Oligodendrocyte Glycoprotein Antibody Disease) or NMOSD (Neuromyelitis Optica Spectrum Disorder) to manifest with mild or no immediate vision loss, especially in early stages or atypical presentations.
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Testing for MOG/AQP4 antibodies: Given your symptoms and the positive ANA, testing for MOG and AQP4 antibodies could provide valuable insights into your neurological symptoms, even if your brain MRI was normal.
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Requesting a spine MRI: An MRI of the spine might be useful to check for lesions or damage suggestive of myelitis, which could correlate with some of your neurological symptoms (tingling, sensation changes).
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Specialists to consult: Ideally, you should follow up with a neuro-ophthalmologist who can assess your optic nerve function further. Additionally, working with a neurologist specializing in autoimmune neurological conditions could provide a comprehensive review of your symptoms.
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Additional tests: Besides the requested antibody tests and potential spinal MRI, it may also be worth examining your blood work further for vitamin deficiencies (like B12) or thyroid issues that could contribute to your symptoms.
Next Steps:
Here’s a structured action plan for you:
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Consult your neuro-ophthalmologist about its importance to test for MOG and AQP4 antibodies if you haven’t done so already, and whether it's prudent to consider a spinal MRI.
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Prepare for your next appointment by documenting all your symptoms in detail, including their frequency and duration, to aid your specialists in understanding your experiences.
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Inquire about monitoring for vitamin deficiencies that might affect neurological health and consider routine checks, especially for B12 and vitamin D levels.
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Explore managing acute symptoms, like shortness of breath and muscle weakness, through symptom management strategies. Techniques like breathing exercises may help alleviate some of your respiratory symptoms related to asthma.
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Stay informed about your conditions and the nature of your symptoms—knowledge can empower you and ease concerns about your health.
Please remember, while it’s important to advocate for your health, your healthcare team can provide the best personalized guidance. Feel free to reach out if you have more specific questions or need further clarification on any point!
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