Visual pathway abnormalities were found in most multiple sclerosis patients despite history of previous optic neuritis

Castro, Stella; Damasceno, Alfredo; Damasceno, Benito Pereira; Vasconcellos, Jose Paulo de; Reis, Fabiano; Iyeyasu, Josie Naomi; Carvalho, Keila Monteiro de

doi:10.1590/0004-282x20130058

Cited by 15 publications

(14 citation statements)

References 26 publications

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“…Optic Neuritis (ON) is a common ophthalmological disorder in these patients [ 7 ] and 1 out of 3 MS patients suffer from visual impairment [ 8 ]. Moreover, the visual pathway can also be targeted by MS despite a history of prior optic neuritis [ 9 ]. Second, the visual pathway can be functionally evaluated with Visual Evoked Potentials (VEP) [ 10 ] and visual function tests, namely visual acuity (VA), visual field and color vision.…”

Section: Resultsmentioning

confidence: 99%

The multiple sclerosis visual pathway cohort: understanding neurodegeneration in MS

et al. 2014

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BackgroundMultiple Sclerosis (MS) is an immune-mediated disease of the Central Nervous System with two major underlying etiopathogenic processes: inflammation and neurodegeneration. The latter determines the prognosis of this disease. MS is the main cause of non-traumatic disability in middle-aged populations.FindingsThe MS-VisualPath Cohort was set up to study the neurodegenerative component of MS using advanced imaging techniques by focusing on analysis of the visual pathway in a middle-aged MS population in Barcelona, Spain. We started the recruitment of patients in the early phase of MS in 2010 and it remains permanently open. All patients undergo a complete neurological and ophthalmological examination including measurements of physical and disability (Expanded Disability Status Scale; Multiple Sclerosis Functional Composite and neuropsychological tests), disease activity (relapses) and visual function testing (visual acuity, color vision and visual field). The MS-VisualPath protocol also assesses the presence of anxiety and depressive symptoms (Hospital Anxiety and Depression Scale), general quality of life (SF-36) and visual quality of life (25-Item National Eye Institute Visual Function Questionnaire with the 10-Item Neuro-Ophthalmic Supplement). In addition, the imaging protocol includes both retinal (Optical Coherence Tomography and Wide-Field Fundus Imaging) and brain imaging (Magnetic Resonance Imaging). Finally, multifocal Visual Evoked Potentials are used to perform neurophysiological assessment of the visual pathway.DiscussionThe analysis of the visual pathway with advance imaging and electrophysilogical tools in parallel with clinical information will provide significant and new knowledge regarding neurodegeneration in MS and provide new clinical and imaging biomarkers to help monitor disease progression in these patients.

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Section: Resultsmentioning

confidence: 99%

The multiple sclerosis visual pathway cohort: understanding neurodegeneration in MS

et al. 2014

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“…48 Visual field sensitivity (as measured by the mean deviation (MD) from age-matched normal values) is reduced in MS patients relative to normal subjects, with the greatest reduction being observed in those eyes with a history of ON. 49,50 Mean deviation is correlated with TD-OCT-derived RNFL thickness in MS eyes with a history of ON, 51,52 although the quantitative relationship with deeper retinal layers remains unstudied. Given that MS patients are prone to fatigue 53 and the adverse effects of fatigue on both visual sensitivity and reliability when performing perimetry, 48 more objective measures of visual function (such as electrophysiology) are likely to be helpful when assessing MS patients.…”

Section: Relationship Of Oct Parameters With Clinical Outcome Measuresmentioning

confidence: 99%

Optical Coherence Tomography in Multiple Sclerosis

et al. 2016

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Retinal optical coherence tomography (OCT) has recently become a vital tool for clinicians and researchers in ophthalmology and, increasingly, in neurology. Optical coherence tomography is quickly and easily performed, well-tolerated by patients, and allows high-resolution viewing of unmyelinated axons and other retinal structures in vivo. These factors have led OCT to find favor as a method of quantifying neuroaxonal loss in multiple sclerosis (MS), and the increasing acceptance of the anterior visual pathway as a model to investigate MS in humans.In this short review, the authors discuss OCT findings in MS research, and the relationships of these structural findings with established functional outcome measures such as visual acuity and electrophysiological examinations. The utility of OCT in patients with acute optic neuritis is emphasized. Optical coherence tomography is a particularly powerful tool when the individual retinal layers are visualized and quantified following the segmentation of scans; this technique shows promise as a method for defining novel MS phenotypes.

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“…Taken together, these findings indicate that MS can lead to damage along the entire color vision pathway [3][4][5]. However, while dyschromatopsia is well documented in MS patients, even in those without a history of Acute Optic Neuritis (AON) [6,7], the precise site of injury producing color vision impairment remains unknown.…”

Section: Introductionmentioning

confidence: 99%

Color vision impairment in multiple sclerosis points to retinal ganglion cell damage

et al. 2015

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Multiple Sclerosis (MS) results in color vision impairment regardless of optic neuritis (ON). The exact location of injury remains undefined. The objective of this study is to identify the region leading to dyschromatopsia in MS patients' NON-eyes. We evaluated Spearman correlations between color vision and measures of different regions in the afferent visual pathway in 106 MS patients. Regions with significant correlations were included in logistic regression models to assess their independent role in dyschromatopsia. We evaluated color vision with Hardy-Rand-Rittler plates and retinal damage using Optical Coherence Tomography. We ran SIENAX to measure Normalized Brain Parenchymal Volume (NBPV), FIRST for thalamus volume and Freesurfer for visual cortex areas. We found moderate, significant correlations between color vision and macular retinal nerve fiber layer (rho = 0.289, p = 0.003), ganglion cell complex (GCC = GCIP) (rho = 0.353, p < 0.001), thalamus (rho = 0.361, p < 0.001), and lesion volume within the optic radiations (rho = -0.230, p = 0.030). Only GCC thickness remained significant (p = 0.023) in the logistic regression model. In the final model including lesion load and NBPV as markers of diffuse neuroaxonal damage, GCC remained associated with dyschromatopsia [OR = 0.88 95 % CI (0.80-0.97) p = 0.016]. This association remained significant when we also added sex, age, and disease duration as covariates in the regression model. Dyschromatopsia in NON-eyes is due to damage of retinal ganglion cells (RGC) in MS. Color vision can serve as a marker of RGC damage in MS.

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Visual pathway abnormalities were found in most multiple sclerosis patients despite history of previous optic neuritis

Cited by 15 publications

References 26 publications

The multiple sclerosis visual pathway cohort: understanding neurodegeneration in MS

The multiple sclerosis visual pathway cohort: understanding neurodegeneration in MS

Optical Coherence Tomography in Multiple Sclerosis

Color vision impairment in multiple sclerosis points to retinal ganglion cell damage

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