Patients with neuromyelitis optica spectrum disorder-optic neuritis (NMOSD-ON) tend to have more severe visual field damage and irregularity than those with idiopathic optic neuritis. They also tend to have a worse prognosis than patients with idiopathic optic neuritis.

For both types of optic neuritis, the 2 most common types of abnormalities were diffuse abnormalities and nerve fiber bundle abnormalities. Neurologic abnormalities, on the other hand, were more common in patients with NMOSD-ON, while central scotoma was more common in those with idiopathic optic neuritis.

Finally, the visual function of patients with NMOSD-ON at 1 month was related to the prognosis of the disease, while that at 3 months was related to prognosis in patients with idiopathic optic neuritis.

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These are the findings of a study published in BMC Ophthalmology, the aim of which was to compare visual field defect evolvement in these 2 conditions.

Read more about the prognosis of NMOSD

The prospective study recruited 33 patients with NMOSD-ON and 71 patients with idiopathic optic neuritis who were followed for at least 6 months. The researchers compared the pattern and recovery pattern of visual field defects, mean defect and pattern standard deviation of the visual field, and best corrected visual acuity at disease onset and at 1, 3, and 6 months after onset.

The results showed that the percentage of visual field defects was higher in patients with NMOSD-ON than in those with idiopathic optic neuritis. Moreover, the mean defect and pattern standard deviation of patients with NMOSD-ON were significantly worse at 1, 3, and 6 months than those of patients with idiopathic optic neuritis. 

There was a positive correlation in mean defect and pattern standard deviation between 1 and 6 months in patients with both conditions. There was a positive correlation in best corrected visual acuity between 1 and 6 months only in patients with NMOSD-ON.

The most common pattern was the quadrant recovery pattern in both groups of patients. 

Reference

Liang J, Zhang Y, Liu K, et al. Comparing evolvement of visual field defect in neuromyelitis optica spectrum disorder-optic neuritis and idiopathic optic neuritis: a prospective study. BMC Ophthalmol. 2022;22:338. doi:10.1186/s12886-022-02510-y

Idiopathic Optic Neuritis Neurologists NMOSD-Optic Neuritis Ophthalmologists