Objective: To review the clinical characteristics of patients with neuromyelitis optica (NMO) and to compare their visual outcome with those of patients with optic neuritis (ON) and multiple sclerosis (MS).
Methods: Thirty-three patients with NMO underwent neuro-ophthalmic evaluation, including automated perimetry along with 30 patients with MS. Visual function in both groups was compared overall and specifically for eyes after a single episode of ON.
Results: Visual function and average visual field (VF) mean deviation were significantly worse in eyes of patients with NMO. After a single episode of ON, the VF was normal in only 2 of 36 eyes of patients with NMO compared to 17 of 35 eyes with MS (P < 0.001). The statistical analysis indicated that after a single episode of ON, the odds ratio for having NMO was 6.0 (confidence interval [CI]: 1.6–21.9) when VF mean deviation was worse than -20.0 dB while the odds ratio for having MS was 16.0 (CI: 3.6–68.7) when better than -3.0 dB.
Conclusion: Visual outcome was significantly worse in NMO than in MS. After a single episode of ON, suspicion of NMO should be raised in the presence of severe residual VF deficit with automated perimetry and lowered in the case of complete VF recovery.
Division of Ophthalmology and Laboratory of Investigation in Ophthalmology (LIM 33) (DBF, RIPR, CF, MLRL); and Department of Neurology (SA-P, DC), University of São Paulo Medical School, São Paulo, Brazil.
Address correspondence to Mário L. R. Monteiro, MD, PhD, Av. Angélica 1757 conj 61, 01227-200, São Paulo, Brazil; E-mail: email@example.com
Supported by a grant from Fundação de Amparo a Pesquisa do Estado de São Paulo FAPESP (No 2009/50174-0), São Paulo, Brazil.
The authors report no conflicts of interest.