Vision-related Quality Of Life And Depression In Patients With Seropositive AQP4-Ab Demyelinating Optic Neuritis

Purpose: Seropositive AQP4-Ab demyelinating optic neuritis(DON)patients have caused more severe visual impairment than seronegative patients.Our aim was to evaluate the vision-related quality of life(VRQo L)and depression in seropositive AQP4-Ab DON patients.Methods: A multi-center,cross-sectional observational study was carried out.All patients and healthy volunteers were recruited in Guangxi Optic Neuritis Treatment Center from June 2016 to August 2020.Serum AQP-4 antibodies were detected by the cell-based assay(CBA).All participants completed both Chinese version of the National Eye Institute Visual Function Questionnaire(CHI-VFQ-25)and Chinese version of Beck Depression Inventory-II(CHI-BDI-II).Results: Finally,26 DON patients with seropositive AQP4-Ab,24 patients with seronegative AQP4-Ab and 106 healthy controls were recruited.All patients were unilateral onset.DON patients with seropositive AQP4-Ab had a median age of 37.0 years(IQR,24.00-52.25),compared to the median age of40.5 years(IQR,25.50-52.00)for seronegative AQP4-Ab patients and 37.5years(IQR,27.75-50.00)for healthy people.The proportion of women with seropositive AQP4-Ab(80.77%)was higher than seronegative AQP4-Ab patients(58.33%)and healthy people(51.89%).DON patients with seropositive AQP4-Ab had a median Log MAR visual acuity in the affected eye of 1.93(IQR,1.74-2.30),compared to median Log MAR visual acuity in the affected eye of1.40(IQR,1.00-1.85)for seronegative AQP4-Ab patients(P<0.05).The median Log MAR visual acuity in the follow eye of the seropositive AQP4-Ab DON patients was 0.50(IQR,0.07-0.94),while the seronegative AQP4-Ab DON patients were 0.35(IQR,0.02-0.60),the difference was not statistically significant(P>0.05).DON patients with seropositive AQP4-Ab had a worse vision-related quality of life than patients with seronegative AQP4-Ab and healthy controls(P<0.001).Also,seropositive AQP4-Ab DON patients have lower scores in most subscales of CHI-VFQ-25 than the other two groups(all P<0.01).The incidence of depression in DON patients with seropositive AQP4-Ab(46.15%)was the highest(P<0.05),and the incidence of major depression(19.23%)was higher than that of seronegative AQP4-Ab DON patients(4.17%)and healthy people(1.89%).More severe VRQo L damage of DON patients is mainly related to more episodes.Conclusion: DON patients with seropositive AQP4-Ab have worse VRQo L and higher incidence of depression.Lower vision-related quality of life may be related to more attacks in patients with DON.Doctors should pay attention to the VRQo L and depression of seropositive AQP4-Ab DON patients during treatment.