QL16
Correlating Blindness with Patient Reported Outcomes, Demographics, and Performance in Nmo
Neuromyelitis optica (NMO) is an autoimmune inflammatory disease of the central nervous system that occurs in both children and adults that can lead to severe neurological deficits, including visual impairment.
PRO are subjective measures that provide insight into patients’ quality of life and perceived functional status and are increasingly used. PRO in pediatric and adult onset NMO have not been correlated to functional status.
Objectives: The aim of this study was to correlate blindness in patients with NMO with patient reported outcomes (PRO), demographics, and performance testing (PT).
Methods: A NMO registry identified patients fulfilling the revised diagnostic criteria for NMO spectrum disorders. PRO, PT, and visual acuities (VA) were obtained from a clinical database and electronic medical record and compared between blind (VA ≤20/200 in ≥ 1 eye) and non-blind. Associations between blindness and PRO or PT were examined using Spearman correlation.
Results: Fifty-one NMO patients (median age 43 years, median age of onset 29, 88.2% female, 39.2% blind) were included in the study. Blind patients were significantly younger (median 29.3 vs. 44.0 years) had an earlier age of disease onset (16.5 vs 36.0 years, p = <0.001) and a longer disease duration (13.5 vs 3.0 years, p = 0.02) compared to non-blind patients. More blind patients used gait assisted devices and had longer times on the 9-hole peg test. Blind patients rated their visual disability worse, yet depression rates were similar in blind and non-blind. Adult onset NMO ranked their quality of lift worse as compared with pediatric onset NMO.
Fifty-one NMO patients (median age 43 years, median age of onset 29, 88.2% female, 39.2% blind) were included in the study. Blind patients were significantly younger (median 29.3 vs. 44.0 years) had an earlier age of disease onset (16.5 vs 36.0 years, p = <0.001) and a longer disease duration (13.5 vs 3.0 years, p = 0.02) compared to non-blind patients. More blind patients used gait assistant devices and had longer times on the 9-hole peg test. Blind patients rated their visual disability worse, yet depression rates were similar in blind and non-blind. Adult onset NMO ranked their quality of life worse as compared with pediatric onset NMO.
Conclusions:
Blindness in NMO is common and was seen in those with early age of onset, longer disease duration, and younger current age. Though blindness was associated with PT and visual PRO, it did not influence depression. Older age of onset was associated with worsening quality of life. Future studies with larger cohorts are needed to better assess PRO in NMO.