A study on patients with neuromyelitis optica spectrum disorder from Eastern India

Background

To study the clinical presentation and response to immunosuppressives in patients with Neuromyelitis Optica Spectrum Disorder (NMOSD) in a tertiary care hospital of eastern India.

Results

There was a female preponderance of the disease (6.5:1) with mean age of disease onset 26.6 years. Isolated ON was the most common presentation at disease onset (60 %). Among motor symptoms at disease onset, only quadriparesis predicted a worse EDSS outcome at last follow up (p = 0.003). Visual acuity ≤6/60 and bilateral involvement was more common in the seropositive patients than in seronegative patients. Anti MOG Antibody was tested in 64.2 % of seronegative patients and was negative. Rituximab was most effective in preventing relapses (no relapses) followed by azathioprine (reduction of ARR of 90.1 %) and mycophenolate (reduction of ARR of 58.6 %). Also the reduction in median EDSS score and median FSS score for vision was greatest for the patients who received rituximab (52.9 % and 33.3 % respectively).

Conclusion

Relapsing course of the disease was frequently observed with isolated optic neuritis being the most common symptom at disease onset. Among the motor features only quadriparesis at disease onset predicted a worse disease outcome. Rituximab was most effective in reducing the median EDSS score on follow up and preventing relapse.