To understand the contribution of disability to quality of life in aquaporin 4 antibody positive neuromyelitis optica spectrum disorder (AQP4-Ab-NMOSD).

AQP4-Ab-NMOSD is associated with severe disability. There is limited data of the effect of visual and motor disability on quality of life. 

The correlations and predictive effects of EDMUS/EDSS and visual acuity on the EQ5D3L and its individual components from 74 patients with AQP4-Ab-NMOSD, outside of relapse, was analysed. Age, sex and race effects were also assessed.   

EDMUS/EDSS was most strongly associated with EQ5D (r2=0.414), with mobility (r2=0.485), self-care (r2=0.303) and usual activities (r2=0.352) being the main drivers and pain having a smaller effect (r2=0.287)(all p<0.001). The strongest correlations were for the total score rather than the TTO or the health status visual analogue score.

Mean bilateral visual acuity (VA) gave slightly better correlations (r2 up to 0.130 p=0.002) than the worst eye VA, with significant but weak correlations with the usual activity (r2=0.08, p=0.014) and anxiety/depression (r2=0.096, p=0.007) components.

EQ5D did not appear to differ between sexes, race nor age.  

Multiple Regression analysis adding in mean visual acuity and age to EDMUS/EDSS slightly improved the model to predict 47.2% of the total EQ5D score. (5-15)