{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:32:08Z","timestamp":1777937528983,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2021,1,6]],"date-time":"2021-01-06T00:00:00Z","timestamp":1609891200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Severe residual visual loss (SRVL) is frequent in neuromyelitis optica spectrum disorders (NMOSD). Identifying higher-risk patients at onset is important to prevent disability accumulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To determine predictors of SRVL in a large NMOSD cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patient characteristics at last visual acuity (VA) evaluation were retrospectively collected. VA was scored 0: better than 20\/40, 1: 20\/40\u201320\/99, 2: 20\/100\u201320\/200, and 3: worse than 20\/200. SRVL was defined as a combined score (VA worst + best eye) \u2a7e 4. Descriptive statistics were used to compare groups and logistic regression to evaluate predictors of VA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>106 patients (mean age at disease onset (AO): 35.8 \u00b1 16.5\u2009years) were included. Patients with SRVL had earlier AO (mean: 26.7 vs 38.0\u2009years) compared to non-SRVL group ( p = 0.005). Patients with AO &lt; 21\u2009years were more likely to have SRVL, be blind, present with binocular optic neuritis, have recurrent optic neuritis, and receive oral therapy first-line than those with AO \u2a7e 21. After adjusting for race, sex, and disease duration, the odds of SRVL were 4.68 times higher in patients &lt; 21 at disease onset (95% CI: 1.53\u201314.34, p = 0.007).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Early AO predicts SRVL in NMOSD, independent of disease duration. High-efficacy therapies should be considered for first-line treatment in this group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1352458520981736","type":"journal-article","created":{"date-parts":[[2021,1,13]],"date-time":"2021-01-13T18:22:07Z","timestamp":1610562127000},"page":"1749-1759","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Early age of onset predicts severity of visual impairment in patients with neuromyelitis optica spectrum disorder"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7303-2332","authenticated-orcid":false,"given":"Gabrielle","family":"Macaron","sequence":"first","affiliation":[{"name":"Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA\/Facult\u00e9 de m\u00e9decine, Universit\u00e9 Saint Joseph de Beyrouth, Beirut, Lebanon; Department of Neurology, H\u00f4tel Dieu de France Hospital, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean","family":"Khoury","sequence":"additional","affiliation":[{"name":"Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Bena","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meagan","family":"Seay","sequence":"additional","affiliation":[{"name":"Moran Eye Center, University of Utah, Salt Lake City, UT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert A","family":"Bermel","sequence":"additional","affiliation":[{"name":"Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9245-9772","authenticated-orcid":false,"given":"Jeffrey A","family":"Cohen","sequence":"additional","affiliation":[{"name":"Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary R","family":"Rensel","sequence":"additional","affiliation":[{"name":"Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, OH, 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