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Comparison of Visual Acuity and Automated Perimetry Findings in Patients With Neuromyelitis Optica or Multiple Sclerosis After Single or Multiple Attacks of Optic Neuritis

Fernandes, Danilo B. MD; Ramos, Renata de Iracema P. MD; Falcochio, Carolina MD; Apóstolos-Pereira, Samira MD; Callegaro, Dagoberto MD, PhD; Monteiro, Mário Luiz Ribeiro MD, PhD

Journal of Neuro-Ophthalmology: June 2012 - Volume 32 - Issue 2 - p 102–106
doi: 10.1097/WNO.0b013e31823a9ebc
Original Contribution
Japanese Abstract

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:

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.

© 2012 Lippincott Williams & Wilkins, Inc.