title: Severe structural and functional visual system damage leads to profound loss of vision-related quality of life in patients with neuromyelitis optica spectrum disorders.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany; Clinical and Experimental Multiple Sclerosis Research Center, Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Schmidt
authors.affiliation: NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Hanna
authors.initials: H
authors.lastname: Zimmermann
authors.affiliation: NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Janine
authors.initials: J
authors.lastname: Mikolajczak
authors.affiliation: NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Frederike C
authors.initials: FC
authors.lastname: Oertel
authors.affiliation: Clinical and Experimental Multiple Sclerosis Research Center, Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Florence
authors.initials: F
authors.lastname: Pache
authors.affiliation: NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Weinhold
authors.affiliation: NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Johann
authors.initials: J
authors.lastname: Schinzel
authors.affiliation: NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany; Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Judith
authors.initials: J
authors.lastname: Bellmann-Strobl
authors.affiliation: Clinical and Experimental Multiple Sclerosis Research Center, Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Klemens
authors.initials: K
authors.lastname: Ruprecht
authors.affiliation: NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany; Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Friedemann
authors.initials: F
authors.lastname: Paul
authors.affiliation: NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany. Electronic address: alexander.brandt@charite.de.
authors.forename: Alexander U
authors.initials: AU
authors.lastname: Brandt
mesh_terms: D000328:Adult; D000368:Aged; D015350:Contrast Sensitivity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009471:Neuromyelitis Optica / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000523:psychology*; D011788:Quality of Life; D012160:Retina / Q000000981:diagnostic imaging / Q000503:physiopathology; D041623:Tomography, Optical Coherence; D014786:Vision Disorders / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000523:psychology*; D014792:Visual Acuity; D055815:Young Adult
keywords: Neuromyelitis optica spectrum disorder; Optic neuritis; Optical coherence tomography; Retinal nerve fibre layer; Vision related quality of life; Visual function