Background: Neuromyelitis optica (NMO) is an inflammatory disease associating optic neuritis and myelitis. Recently, several works showed that optical coherence tomography (OCT) should be an interesting method of disease severity. However, to date there is no study concerning longitudinal follow-up of visual functions in NMO. The aim of this study was to evaluate the interest of several visual technics for the evaluation of progression of visual dysfunctions in NMO. Patients and methods: Thirty NMO patients (60 eyes), including 20 women and 10 men with a mean age of 43.7+/-12.3 years, were prospectively evaluated clinically and by a whole neuro-ophthalmological work-up, including visual acuity (VA), funduscopy, visual evoked potential (VEP), visual field (VF) and optic coherence tomography (OCT). All patients were tested at baseline after a mean duration of the disease of 6.1 years and after a mean time of follow-up of 18 months (12-36). Results: Mean VA was similar at the 2 time evaluations (0.77+/-0.36 vs 0.77+/-0.35. Mean VF defect slowly decreased but the difference was not significant (-5.9+/-1.3db vs -5.3+/-1.3db, NS). On contrary mean retinal thickness on OCT decreased from 87.4+/-23.3?m to 79.7+/-22.4?m (p=0.006). These modifications were independent to the occurrence of relapses (n=13) and especially optic neuritis episodes (n=6). Conclusion: OCT seems to be a more sensitive test than VA or VF for monitoring ophthalmological function in NMO. This “easy to perform” method should be generalized in the follow-up of NMO. A possible “plancher” effect could be observed in patients with a very long course of the disease. Longer follow-up is warranted in order to determine whether or not this test is a good predictor for long term prediction.
Read More: Longitudinal follow-up of vision in a neuromyelitis optica cohort