Visual disability in neuromyelitis optica spectrum disorders: prognostic prediction models

Area of Science:

• Neuroimmunology
• Ophthalmology
• Neurology

Background:

• Neuromyelitis Optica Spectrum Disorder (NMOSD) is an autoimmune CNS inflammatory disease.
• Attacks can lead to progressive and severe visual disability.
• Predicting visual disability risk is crucial for patient management.

Purpose of the Study:

• To develop and validate prognostic models for visual disability risk in NMOSD patients at 1, 3, and 5 years.
• To identify key predictors of visual disability in NMOSD.

Main Methods:

• Retrospective analysis of NMOSD patient medical records.
• Utilized LASSO and Cox regression to identify visual disability predictors.
• Developed nomograms and risk scores for predicting visual disability probability.

Main Results:

• Identified predictors: optic neuritis onset, higher annual relapse rate, no maintenance immunotherapy, initial severe attack, male sex, age at onset, and AQP4-IgG serology.
• Developed models with high discrimination (C-index ~0.9) and clinical usefulness.
• Successfully discriminated between high-risk and low-risk patients.

Conclusions:

• Predictive models and nomograms for visual disability in NMOSD were successfully developed.
• High-risk NMOSD patients require intensified treatment and management strategies.
• Proactive management can mitigate unfavorable visual outcomes in NMOSD.