Severe structural and functional visual system damage leads to profound loss of vision-related quality of life in patients with neuromyelitis optica spectrum disorders

Mult Scler Relat Disord. 2017 Jan:11:45-50. doi: 10.1016/j.msard.2016.11.008. Epub 2016 Nov 20.


Background: Neuromyelitis optica spectrum disorders (NMOSD) are characterized by devastating optic neuritis attacks causing more structural damage and visual impairment than in multiple sclerosis (MS). The objective of this study was to compare vision-related quality of life in NMOSD and MS patients and correlate it to structural retinal damage and visual function.

Methods: Thirty-one NMOSD and 31 matched MS patients were included. Vision-related quality of life was assessed with the 39-item National Eye Institute Visual Function Questionnaire (NEI-VFQ). All patients underwent retinal optical coherence tomography and visual acuity and contrast sensitivity measurements.

Results: Vision-related quality of life was reduced in NMOSD compared to MS patients. This difference was driven by a higher incidence of bilateral and more severe optic neuritis in the NMOSD group. Retinal thinning and visual impairment were significantly greater in the NMOSD cohort. Lower vision-related quality of life was associated with more retinal damage and reduced visual function as assessed by visual acuity and contrast sensitivity.

Conclusion: NMOSD-related bilateral ON-attacks cause severe structural damage and visual impairment that lead to severe loss of vision-related quality of life. The NEI-VFQ is a helpful tool to monitor vision-related quality of life in NMOSD patients.

Keywords: Neuromyelitis optica spectrum disorder; Optic neuritis; Optical coherence tomography; Retinal nerve fibre layer; Vision related quality of life; Visual function.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Contrast Sensitivity
  • Cross-Sectional Studies
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Neuromyelitis Optica / complications*
  • Neuromyelitis Optica / diagnostic imaging
  • Neuromyelitis Optica / physiopathology
  • Neuromyelitis Optica / psychology*
  • Quality of Life*
  • Retina / diagnostic imaging
  • Retina / physiopathology
  • Tomography, Optical Coherence
  • Vision Disorders / complications*
  • Vision Disorders / diagnostic imaging
  • Vision Disorders / physiopathology
  • Vision Disorders / psychology*
  • Visual Acuity
  • Young Adult