A study recently published in the Journal of Neuro-Ophthalmology investigated multiple sclerosis-based ocular symptoms and the level of these manifestations.
Give me some background first.
Multiple sclerosis (MS) is a common disabling neurological disease that affects young adults, with a general onset age of 20 to 40 years. Ocular involvement is a manifestation of MS that can lead to varying degrees of disability and impairment.
With this in mind, researchers investigated the frequency and severity of ocular symptoms among patients diagnosed with MS.
Now, talk about the study.
This was a retrospective, population-based study that examined patients with MS between January 1, 1998, and December 31, 2011.
Participants were selected using the Rochester Epidemiology Project, which is a collaboration of medical facilities’ electronic health records (EHRs) in Minnesota and Wisconsin.
Who was included in the study?
A total of 116 patients (66% female; average onset age of 36 years) with MS were evaluated and followed for a median of 11.3 years. Diagnosis for MS was confirmed based on:
- Neuroimaging
- Cerebrospinal fluid studies
- Serum studies
Findings?
Of the 116 participants, over half (53%) of patients experienced MS-related neuro-ophthalmic manifestations.
About 28% of participants experienced visual symptoms as their presenting indication of MS, with optic neuritis as the most common (22%).
Tell me more.
In terms of MS-related ocular symptoms that developed over time, the following were the most common:
- Optic neuritis (37%)
- Internuclear ophthalmoplegia (16%)
- Nystagmus (13%)
Anything else?
Optic neuritis was mostly unilateral (40/43, 93%), and 16% had a visual acuity (VA) of 20/200 or worse at nadir.
However, 95% (35/37) of optic neuritis cases resolved to VA of 20/40 or better.
Expert opinion?
Per the authors of the study: “Our work underscores the importance of collaboration between neurologists and ophthalmologists for the diagnosis and management of patients with MS.”
They continued: “Several ophthalmologic manifestations of the disease may require treatment, such as prism for diplopia, or can be subtle and therefore missed without a detailed ophthalmic examination.”
Take home.
Overall, the study displays findings on the frequency of MS-based ocular involvement and manifestations.
The authors concluded: “Dedicated ocular examinations including orthoptics examination for ocular motor disorders and optic neuropathy testing (color plates, OCT and visual field examinations) are helpful both for making baseline diagnoses and for tracking disease progression.”