Abstract| Volume 37, 101543, January 2020

Neuromyelitis Optica Spectrum Disorders in Arabian Gulf (NMOAG): A Newly Established Registry

      To describe the clinical and radiological characteristics of neuromyelitis optica spectrum disorders (NMOSD) in Arabian Gulf region according to the patients’ anti-Aquaporin 4 antibody (anti-AQP4-Ab) serostatus
      Retrospective multicentre study of hospital records of NMOSD patients based on 2015 consensus criteria
      One hundred forty four patients were identified, of whom sixty four percent (64.3%) were tested positive for AQP4 antibodies. The mean age at onset and mean disease duration were 31±12, and 7±6 years respectively. Patients were found to be predominantly female with a ratio of 4.7:1 in relapsing and monophasic courses. Optic neuritis (ON) was the most frequent presentation among seropositives and seronegatives patients. The proportion of patients (54.3%) with visual acuity of ≤ 0.1 was higher in seropositive group (p=0.018). Primary presenting symptoms of transverse myelitis (TM) were observed in 29% of patients, and was a major reason of hospitalization (p<0.001). Relapsing course 115 (80%) was more common than monophasic 29 (20%). There was no significant difference according to the sero-status in terms of age of onset, course, relapse rates, and efficacy outcomes except for oligoclonal bands (OCB), which were more often present in seronegative patients (p=0.054). Several disease modifying therapies were instituted including steroids or immunosuppressives, mostly, rituximab and azathioprine in the cohort.
      This is the first descriptive NMOSD cohort in the Arabian Gulf region. Seropositive patients were more prevalent with female predominance. Relapsing course was more common than monophasic. Rituximab and azathioprine were more efficient among immunosuppressives irrespective of the serostatus