AUTHOR=Liu Yihan , Meng Li , Li Jiyuan , Wang Xiao , Zhang Xiaoman , Kong Xiangzeng , Zhang Yongzhi 

TITLE=Effects of eculizumab and rituximab on visual function, motor function and social quality in patients with NMOSD: a comparative study

JOURNAL=Frontiers in Neurology

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2025.1698950

DOI=10.3389/fneur.2025.1698950

ISSN=1664-2295

ABSTRACT=ObjectiveTo compare the effects of eculizumab and rituximab on visual function, motor function, and social quality of life in patients with aquaporin-4 antibody positive neuromyelitis optica spectrum disorder (NMOSD).MethodsThis retrospective study included NMOSD patients treated with eculizumab (EG, n = 114) or rituximab (CG, n = 114) at the Department of Neurology, First Hospital of Hebei Medical University, and the First Hospital of Shanxi Medical University between January 2018 and August 2024. Patients were followed for 6 months to assess changes in visual, motor, and social outcomes.ResultsBaseline characteristics, including demographics, disease duration, AQP4-IgG status, annual recurrence rate, EDSS score, and comorbidities, were comparable between groups (P > 0.05). Both groups showed gradual improvement in visual acuity after treatment (P < 0.05). However, the EG demonstrated significantly better uncorrected visual acuity at 1, 3, and 6 months (P < 0.001) and higher corrected visual acuity (P < 0.05). Visual field defects decreased more in the EG (61.40%−33.33%) compared with the CG (64.91%−50.88%, P < 0.05). Abnormal color vision improved in both groups, with greater reduction in the EG, though not statistically significant at 6 months (P = 0.065). Motor function outcomes showed significant time, group, and interaction effects (P < 0.001). The EG achieved higher Fugl-Meyer Assessment (FMA) scores and lower Modified Ashworth Scale (MAS) scores at all time points (P < 0.05). Social function (SFS) improved significantly in both groups, with greater gains in the EG (P < 0.001). Anxiety (HAMA) and depression (HAMD) scores decreased in both groups, but reductions were more pronounced in the EG (P < 0.001).ConclusionNMOSD significantly impairs visual, motor, and social functions. Eculizumab demonstrated superior efficacy over rituximab in improving functional outcomes and quality of life, supporting its role as an effective therapeutic option for NMOSD.