• Danilo B Fernandes, Renata de Iracema P Ramos, Carolina Falcochio, Samira Apóstolos-Pereira, Dagoberto Callegaro, and Mário Luiz Ribeiro Monteiro.
• Division of Ophthalmology and Laboratory of Investigation in Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil.
• J Neuroophthalmol. 2012 Jun 1; 32 (2): 102-6.

ObjectiveTo review the clinical characteristics of patients with neuromyelitis optica (NMO) and to compare their visual outcome with those of patients with optic neuritis (ON) and multiple sclerosis (MS).MethodsThirty-three patients with NMO underwent neuro-ophthalmic evaluation, including automated perimetry along with 30 patients with MS. Visual function in both groups was compared overall and specifically for eyes after a single episode of ON.ResultsVisual function and average visual field (VF) mean deviation were significantly worse in eyes of patients with NMO. After a single episode of ON, the VF was normal in only 2 of 36 eyes of patients with NMO compared to 17 of 35 eyes with MS (P < 0.001). The statistical analysis indicated that after a single episode of ON, the odds ratio for having NMO was 6.0 (confidence interval [CI]: 1.6-21.9) when VF mean deviation was worse than -20.0 dB while the odds ratio for having MS was 16.0 (CI: 3.6-68.7) when better than -3.0 dB.ConclusionVisual outcome was significantly worse in NMO than in MS. After a single episode of ON, suspicion of NMO should be raised in the presence of severe residual VF deficit with automated perimetry and lowered in the case of complete VF recovery.

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