MS Functional Composite Scores with a Visual Component Added Capture Axonal Loss in Patients with Multiple Sclerosis

Retinal nerve fiber layer (RNFL) thickness by optical coherence tomography (OCT) is increasingly recognized as a marker for axonal loss in multiple sclerosis (MS). RNFL thinning is associated with brain atrophy by MRI, suggesting that this measure may reflect more global aspects of disease. The MS Functional Composite (MSFC) currently lacks a visual component, but studies have shown that addition of low-contrast letter acuity increases the capacity of the MSFC to reflect overall neurological impairment.