The detection of AQP4-IgG predicts relapses of myelitis and optic neuritis in adults and children with NMOSD, with cumulative neurological disability, justifying prompt initiation of immunosuppressive therapy (74) with currently available treatment options: rituximab, mycophenolate mofetil, and azathioprine (75, 76, 91, 94), until more experience and knowledge regarding safety in children is gained about newer agents such as eculizumab, satralizumab, and tocilizumab. This evidence concerns the gene AQP4 and optic neuritis.