Relation of Visual Function to Retinal Nerve Fiber Layer Thickness in Multiple Sclerosis

Fisher, Jerome P.; Jacobs, Dina; Markowitz, Clyde; Galetta, Steven; Volpe, Nicholas J.; Nano-Schiavi, M. Ligia; Baier, Monika; Frohman, Elliot M.; Winslow, Heather; Frohman, Teresa C.

doi:10.1016/j.ophtha.2005.10.040

Cited by 605 publications

(623 citation statements)

References 45 publications

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“…This pattern of higher correlation for worse eyes may reflect the fact that a substantial proportion of our patient cohort had MS, which is a disorder that frequently produces subtle loss of function and axonal loss even in eyes with 20/20 or better visual acuity and no history of acute optic neuritis. 1,31,32 Among patients with disorders other than MS in this study, correlations with NEI-VFQ-25 and NEI-VFQ-25 ϩ Supplement scores were greater for better eyes (r s ϭ 0.38 vs r s ϭ 0.31 for worse eyes for both questionnaires).…”

Section: The Results Of This Investigation Demonstratementioning

confidence: 59%

“…Patients who were evaluated by neuro-ophthalmologists in the Department of Neurology at the University of Pennsylvania were invited to participate. The Pennsylvania neuro-ophthalmology group follows a large cohort of patients with MS 31,32 and patients with a variety of other conditions that are associated with afferent and efferent visual dysfunction. Disease-free control subjects included staff and family members of patients who participated in this study and who had binocular visual acuities of 20/20 or better.…”

Section: Methodsmentioning

confidence: 99%

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Validation and Test Characteristics of a 10-Item Neuro-Ophthalmic Supplement to the NEI-VFQ-25

Raphael

Galetta

Jacobs

et al. 2006

American Journal of Ophthalmology

101

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and 10-Item Supplement were administered concurrently to patients and disease-free control subjects. High-contrast visual acuities with patient usual distance correction were measured with the use of Early Treatment Diabetic Retinopathy Study (ETDRS) charts.• RESULTS: Diagnoses for patients (n ‫؍‬ 215) included optic neuritis, multiple sclerosis, idiopathic intracranial hypertension, ischemic optic neuropathy, stroke, ocular myasthenia gravis, ocular motor palsies, and thyroid eye disease. Scores for the 10-Item Supplement had a significant capacity to distinguish patients vs disease-free control subjects that was independent of the NEI-VFQ-25 composite score (odds ratio in favor of patient vs control status for 10-point worsening in Supplement scores: 2.7 [95% confidence interval [CI], 1.6, 4.6]; P < .001, logistic regression models that account for NEI-VFQ-25 composite score, age, and gender). Patients with visual dysfunction (binocular Snellen equivalents worse than 20/20) had significantly lower mean scores (9 -21 points lower); these differences remained significant after accounting for age and gender (P > .001, linear regression). Supplement items and composite scores demonstrated appropriate degrees of internal consistency reliability.•

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Section: The Results Of This Investigation Demonstratementioning

confidence: 59%

Section: Methodsmentioning

confidence: 99%

Validation and Test Characteristics of a 10-Item Neuro-Ophthalmic Supplement to the NEI-VFQ-25

Raphael

Galetta

Jacobs

et al. 2006

American Journal of Ophthalmology

101

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“…The individual relationship between RGC neuroaxonal loss or VEP latency delay with worsening LCVA has been demonstrated previously 14, 15, 24, 27, 38, 39. However, the associations found in our study were generally stronger, possibly due to the use of asymmetry analysis, which eliminates the effect of intersubject variability.…”

Section: Discussionmentioning

confidence: 62%

“…OCT measurement of inner retinal layers (including the retinal nerve fiber layer (RNFL) has been validated as an accurate measure on axonal loss in anterior visual pathway and has been extensively applied to the investigation of MS 14, 15, 16, 17, 18. Thinning of the RNFL identifies retrograde axonal degeneration following damage to the optic nerve or the optic tract, providing an opportunity to quantitatively assess axonal damage associated with ON.…”

Section: Introductionmentioning

confidence: 99%

Pathophysiological basis of low contrast visual acuity loss in multiple sclerosis

Triplett

Yiannikas

Barnett

et al. 2018

Ann Clin Transl Neurol

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ObjectiveThere is currently an urgent need for reliable clinical biomarkers of remyelination to be used in Phase 2 and Phase 3 clinical trials. Low contrast visual acuity (LCVA) has been suggested as a functional measure of the integrity of the visual pathway. Therefore, the aim of this study was to elucidate the potential contribution of axonal loss and demyelination to LCVA loss in MS patients.MethodIn this study, 50 consecutive relapsing remitting MS patients with a previous history of unilateral optic neuritis were enrolled. Using the linear regression model, we assessed the relative contribution of multifocal Visual Evoked Potentials (mfVEP) latency and Retinal Nerve Fiber Layer (RNFL) thickness to LCVA deficit.ResultsIntereye asymmetry of mfVEP latency and RNFL thickness correlated significantly with intereye asymmetry of LCVA (P < 0.001). A linear regression model demonstrated increased predictive power of LCVA when mfVEP latency and RNFL thinning were combined (reaching R 2 = 0.67) and confirmed a higher predictive value of RNFL thinning compared to mfVEP latency delay for both contrast levels. However, elimination of subjects with severe axonal loss dramatically increased the relative contribution of mfVEP latency, with contribution of RNFL thickness losing significance for both 1.25% and 2.5% LCVA.InterpretationWhile retinal ganglion cell axonal loss is a superior predictor of LCVA, the degree of demyelination contributes significantly to worsening of LCVA, particularly when patients with severe axonal loss are excluded. These results support the feasibility of using LCVA as a functional biomarker in remyelination therapy trials, providing appropriate patient's selection criteria are implemented.

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“…However, MS patients with unaffected or mildly affected eyes frequently reported inadequate quality of vision in the present study. Other authors have attempted to correlate visual findings in MS and, except for patients with clearly affected eyes, no important correlation has been described [20][21][22][23] . In fact, the common conclusion is that MS patients have more visual complaints and a variety of ophthalmological abnormalities that warrant comprehensive examination.…”

Section: Resultsmentioning

confidence: 99%

Sight-dependent quality of life and ophthalmic findings in a group of Brazilian patients with multiple sclerosis

Fragoso

Nosé

Nosé³

et al. 2011

Arq. Neuro-Psiquiatr.

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Objective: To assess the visual quality of life in patients with multiple sclerosis (MS), and to observe whether this parameter could be correlated to the findings of the ophthalmologic examination. Method: The translated and validated 25-Item National Eye Institute Visual Function Questionnaire (VFQ-25) was used to assess the visual quality of life. Clinical data on MS, visual acuity, visual fields, optic coherence tomography (OCT) and disc cupping were used for assessing correlation with VFQ-25. Results: The mean VFQ-25 value was 78.6±18.2% in 27 patients. VFQ-25 did not correlate with patients' ages, with disability (EDSS), disease duration or medication use. Visual acuity showed a relatively poor (<60%) correlation to VFQ-25, while no correlation could be established between visual fields, OCT and disc cupping with VFQ-25. Conclusion: MS patients present several alterations in their eyes and sight that cannot be assessed by isolated measures. Ophthalmological examination of these patients must include many parameters not usually used in standard ophthalmologic consultations. Key words: multiple sclerosis, ophthalmology, visual acuity, visual fields, optic coherence tomography, quality of life.Qualidade de vida visual e achados oftálmicos em um grupo de pacientes brasileiros com esclerose múltipla RESUMO Objetivo: Avaliar a qualidade de vida visual de pacientes com esclerose múltipla (EM) e observar se este parâmetro pode ser relacionado aos achados do exame oftalmológico. Método: O questionário traduzido e validado 25-Item National Eye Institute Visual Function Questionnaire (VFQ-25) foi utilizado para avaliar a qualidade de vida visual. Dados clínicos da EM, acuidade visual, campo visual, tomografia de coerência óptica (OCT) e escavação do disco foram utilizados para correlação com VFQ-25. Resultados: A média do VFQ-25 foi 78,6±18,2% em 27 pacientes. VFQ-25 não se correlacionou com a idade dos pacientes, com a incapacidade (EDSS), duração da doença ou medicação em uso. A acuidade visual mostrou uma correlação relativamente pobre (<60%) com VFQ-25, enquanto não foi observada nenhuma correlação entre campo visual, OCT e escavação de disco com VFQ-25. Conclusão: Pacientes com EM apresentam diversas alterações oculares e na visão que não podem ser avaliadas por medidas isoladas. O exame oftalmológico destes pacientes deve incluir parâmetros que não são habitualmente utilizados em consultas oftalmológicas padronizadas. Palavras-Chave: esclerose múltipla, oftalmologia, acuidade visual, campo visual, tomografia de coerência óptica, qualidade de vida.

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Relation of Visual Function to Retinal Nerve Fiber Layer Thickness in Multiple Sclerosis

Cited by 605 publications

References 45 publications

Validation and Test Characteristics of a 10-Item Neuro-Ophthalmic Supplement to the NEI-VFQ-25

Validation and Test Characteristics of a 10-Item Neuro-Ophthalmic Supplement to the NEI-VFQ-25

Pathophysiological basis of low contrast visual acuity loss in multiple sclerosis

Sight-dependent quality of life and ophthalmic findings in a group of Brazilian patients with multiple sclerosis

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