Comparison of vision-related quality of life in NMOSD and MOGAD
- PMID: 40157039
- DOI: 10.1016/j.msard.2025.106392
Comparison of vision-related quality of life in NMOSD and MOGAD
Abstract
Background: Aquaporin-4 antibody positive neuromyelitis spectrum disorder (AQP4+ NMOSD) and myelin oligodendrocyte glycoprotein antibody disease (MOGAD) are both associated with vision loss due to optic neuritis (ON), although evidence suggests more severe structural damage in NMOSD. The validated National Eye Institute Visual Function Questionnaire (VFQ) may be used to evaluate patients' perceptions of how vision impairment affects their lives.
Objective: To compare vision-related quality of life in AQP4+ NMOSD and MOGAD using the NEI-VFQ.
Methods: Participants with AQP4+ NMOSD and MOGAD, 18 years of age and older, were enrolled through the Canadian NMOSD and other atypical demyelinating diseases cohort study (CANOPTICS) at six Canadian centers and consented to enter the patient-reported outcomes sub-study. Participants completed the VFQ at study entry. We compared composite VFQ scores and subscale scores in all participants with NMOSD and MOGAD, those with a history of any ON, and those with a history of bilateral simultaneous ON. We used a multivariable linear regression model to evaluate the association of VFQ composite score with disease type (NMOSD versus MOGAD), age, sex at birth, disease duration, history of unilateral ON, history of bilateral ON, and visual functional system score (FSS).
Results: There were 58 NMOSD participants, 49 (84.5 %) female, mean (SD) age 48.6 (14.8) years, and 42 MOGAD participants, 27 (64.3 %) female, mean (SD) age 45.2(15.1) years. Thirty-five (60.3 %) participants with NMOSD had a history of any ON and 11(19.0 %) of bilateral ON. For MOGAD, 30 (71.4 %) participants had a history of any ON and 14 (33.3 %) of bilateral ON. Mean (SD) VFQ composite scores were 82.2 (17.9) in NMOSD and 83.7 (17.6) in MOGAD for the full cohort; 75.0 (19.9) in NMOSD and 80.4 (18.7) in MOGAD for those with any history of ON; and 70.2 (25.6) in NMOSD and 74.9 (21.8) in MOGAD for bilateral ON. Composite scores did not differ significantly between participants with NMOSD and MOGAD in the full cohort or ON sub-groups. However, history of bilateral ON (β=-13.2, p = 0.0008) and higher visual FSS (β=-4.9, p < 0.0001) were associated with lower VFQ composite scores.
Conclusion: In this Canadian multi-center cohort, vision-related quality of life was impaired in both NMOSD and MOGAD, without significant differences observed in scores. Vision-related quality of life assessment offers unique insights into the functional impact of vision loss, and should be considered as an outcome measure to evaluate visual disability in NMOSD and MOGAD in addition to visual acuity.
Keywords: AQP4+; MOGAD; NMOSD; Quality of life; Vision.
Copyright © 2025 The Author(s). Published by Elsevier B.V. All rights reserved.
Conflict of interest statement
Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Mark Freedman has received research or educational grants from Sanofi-Genzyme Canada. He has received consulting fees or honoraria from Alexion/Astra Zeneca, BiogenIdec, EMD Inc./EMD Serono/Merck Serono, Find Therapeutics, Hoffman La-Roche, Horizon Therapeutics, Novartis, Quanterix, Sanofi-Genzyme, Teva Canada Innovation. He has served as a member of a company advisory board, board of directors or other similar group for Alexion/Astra Zeneca, Actelion/Janssen (J&J), Atara Biotherapeutics, Bayer Healthcare, Celestra Health, EMD Inc./Merck Serono, Find Therapeutics, Hoffman La-Roche, Novartis, Sanofi-Genzyme, Setpoint Medical. He has been part of a speaker's bureau for Hoffman La-Roche, Novartis, and EMD Inc. Liesly Lee is a site investigator for studies funded by Roche, Novartis and Sanofi Aventis. He has received consultation fees from Alexion, Biogen, Bristol Myers Squibb, EMD Serono, Novartis, Roche, Amgen and Sanofi Aventis. Ruth Ann Marrie receives research funding from: CIHR, MS Canada, Crohn's and Colitis Canada, National Multiple Sclerosis Society, CMSC, the Arthritis Society and the US Department of Defense, and is a co-investigator on studies receiving funding from Biogen Idec, Roche Canada and the Pfizer Foundation. Sarah Morrow has served as an advisory board member or received consulting fees from Biogen Idec; Bristol Myers Squibb/Celgene; EMD Serono; Novartis; Roche; Sanofi Genzyme; Teva Neurosciences. She has participated in a speaker's bureau for Biogen Idec; Bristol Myers Squibb/Celgene; EMD Serono; Novartis; Roche; Sanofi Genzyme. She has received research support from Biogen Idec; Novartis; Roche; Sanofi Genzyme. She has participated as a site investigator in clinical trials sponsored by AbbVie; Bristol Myers Squibb/Celgene; EMDSerono; Novartis; Genzyme; Roche; Sanofi Genzyme. ennifer McCombe has received consultant fees from Amgen, Novartis and Roche and honoraria from the AAN. Natalie Parks has accepted honoraria and consulting fees from Biogen, Bristol Myers Squibb, EMD Serono, Novartis, Roche, and Sanofi. Penelope Smyth has received research support from Biogen Pharmaceuticals and MS Canada.; Speakers Bureau/Honoraria: MS Society of Canada. Consulting Fees: Novartis Pharmaceuticals, Roche Canada, STEDT, Biogen Idec Canada, EMD Serono, Bristol-Myers Squibb, Alexion Canada, Sanofi Genzyme Canada. Dalia L. Rotstein has received research funding from MS Canada, the National MS Society, CMSC, University of Toronto Division of Neurology, Peter and Susan Gordon, Alexion, and Roche Canada. She has received speaker or consultant fees from Alexion, Amgen, Biogen, EMD Serono, Novartis, Roche, Sanofi Aventis and Touch IME.
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