Abstract
AimTo evaluate structural changes in the retina and their correlation with visual dysfunction in patients with multiple sclerosis.MethodsPatients with multiple sclerosis (n = 84) and healthy controls (n = 84) underwent structural evaluation of the retinal nerve fiber layer, and macular and ganglion cell layer thicknesses using Spectral domain optical coherence tomography (SD-OCT). All subjects underwent high and low contrast visual acuity, color vision (using the Farnsworth and L´Anthony desaturated D15 color tests), and contrast sensitivity vision using the Pelli Robson chart and CSV 1000E test.ResultsMacular, retinal nerve fiber layer, and ganglion cell layer thinning was observed in multiple sclerosis patients compared to healthy controls (p<0.05). High- and low-contrast visual acuity and contrast sensitivity vision at four different spatial frequencies were significantly reduced in comparison with healthy subjects (p<0.05). Macular, retinal nerve fiber layer and ganglion cell layer measurements correlated with high and low contrast visual acuity, and contrast sensitivity vision. Contrast sensitivity vision was the functional parameter that most strongly correlated with the structural measurements in multiple sclerosis and was associated with ganglion cell layer measurements. The L´Anthony color vision score (age-corrected color confusion index) was associated with macular measurements.ConclusionsPatients with multiple sclerosis had visual dysfunction that correlated with structural changes evaluated by SD-OCT. Macular and ganglion cell layer measurements may be good indicators of visual impairment in multiple sclerosis patients.
Highlights
Optic nerve atrophy and thinning of the peripapillary retinal nerve fiber layer (RNFL) are two typical findings of patients with multiple sclerosis (MS), with or without a history of optic neuritis (ON)
Retinal nerve fiber layer, and ganglion cell layer thinning was observed in multiple sclerosis patients compared to healthy controls (p
High- and low-contrast visual acuity and contrast sensitivity vision at four different spatial frequencies were significantly reduced in comparison with healthy subjects (p
Summary
Optic nerve atrophy and thinning of the peripapillary retinal nerve fiber layer (RNFL) are two typical findings of patients with multiple sclerosis (MS), with or without a history of optic neuritis (ON). Axonal loss is considered to be the main cause of disability in MS.[1,2,3] Neuronal loss is, increasingly recognized as a biomarker that correlates with disability in MS patients.[4,5,6,7]. Several studies have reported a correlation between axonal loss observed in the optic nerve and visual dysfunction in MS.[1,8]. Segmentation analysis of the various retinal layers made possible by new software for digital imaging techniques in ophthalmology have provided a more specific measurement of the retinal ganglion cell layer and the inner plexiform layer complex (GCIPL) and suggest a correlation between axonal and neuronal loss and visual dysfunction in MS patients.[9,10]
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