| Achoimre: | <h4>Background</h4> <p>Neuromyelitis optica spectrum disorder with aquaporin4-immunoglobulin G (NMOSD-AQP4) is an inflammatory demyelinating disease characterised by a high female predominance. However, the effect of gender in patients with NMOSD-AQP4 has not been fully evaluated, particularly in Asian populations.</p> <h4>Objective</h4> <p>To determine the effect of gender in clinical manifestations and prognosis of patients with NMOSD-AQP4 among Asians.</p> <h4>Methods</h4> <p>The demographics, clinical and radiological characteristics, pattern reversal visual evoked potential (VEP) test results, and prognosis of 106 patients (18 male) with NMOSD-AQP4 were assessed.</p> <h4>Results</h4> <p>Male patients had a higher age at onset (48.7 years vs 41 years, p =0.037), higher tendency to manifest as isolated myelitis (67% vs. 28%, p = 0.005), fewer optic neuritis attacks per year (0.08 vs. 0.27, p < 0.001), and shorter relative P100 latency on VEP testing (97.1% vs 108.3%, p = 0.001). Moreover, male gender was significantly associated with the absence of optic neuritis attacks independent of their age of onset. </p> <h4>Conclusion</h4> <p>In Asian NMOSD-AQP4 patients gender impacts on disease onset age and site of attack. This may be an important diagnostic clue in NMOSD-AQP4 patients with limited manifestations and suggests a better visual prognosis.</p>
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