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Fovea morphometry and a statistical classification approach were used to investigate if foveal changes in NMOSD are independent of ON and progressive.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective longitudinal study of 27 AQP4\u2010IgG + NMOSD patients (49 eyes; 15 ON eyes and 34 eyes without a history of ON [NON eyes]), follow\u2010up median (first and third quartile) 2.32 (1.33\u20133.28), and 38 healthy controls (HCs) (76 eyes), follow\u2010up median (first and third quartile) 1.95 (1.83\u20132.54). The peripapillary retinal nerve fibre layer thickness and the volume of combined ganglion cell and inner plexiform layer as measures of neuroaxonal damage from ON were determined by optical coherence tomography. Nineteen foveal morphometry parameters were extracted from macular optical coherence tomography volume scans. Data were analysed using orthogonal partial least squares discriminant analysis and linear mixed effects models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At baseline, foveal shape was significantly altered in ON eyes and NON eyes compared to HCs. Discriminatory analysis showed 81% accuracy distinguishing ON vs. HCs and 68% accuracy in NON vs. HCs. NON eyes were distinguished from HCs by foveal shape parameters indicating widening. Orthogonal partial least squares discriminant analysis discriminated ON vs. NON with 76% accuracy. In a follow\u2010up of 2.4 (20.85) years, no significant time\u2010dependent foveal changes were found.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The parafoveal area is altered in AQP4\u2010Ab seropositive NMOSD patients suggesting independent neuroaxonal damage from subclinical ON. Longer follow\u2010ups are needed to confirm the stability of the parafoveal structure over time.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.14766","type":"journal-article","created":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T18:18:10Z","timestamp":1612808290000},"page":"2280-2293","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Foveal changes in aquaporin\u20104 antibody seropositive neuromyelitis optica spectrum disorder are independent of optic neuritis and not overtly progressive"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8720-9397","authenticated-orcid":false,"given":"Adriana","family":"Roca\u2010Fern\u00e1ndez","sequence":"first","affiliation":[{"name":"Nuffield Department of Clinical Neurosciences University of Oxford Oxford UK"},{"name":"Department of Neurology\/Neuroimmunology Multiple Sclerosis Centre of Catalonia (Cemcat) Hospital Universitari Vall 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