Visual Pathway Axonal Loss in Benign Multiple Sclerosis

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Title Journal of Neuro-Ophthalmology, June 2012, Volume 32, Issue 2
Date 2012-06
Language eng
Format application/pdf
Type Text
Publication Type Journal Article
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
ARK ark:/87278/s65m9bs4
Setname ehsl_novel_jno
ID 227313
Reference URL https://collections.lib.utah.edu/ark:/87278/s65m9bs4

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Title Visual Pathway Axonal Loss in Benign Multiple Sclerosis
Creator Galetta, Kristin M; Graves, Jennifer; Talman, Lauren S; Lile, Deacon J; Frohman, Elliot M; Calabresi, Peter A; Galetta, Steven L; Balcer, Laura J
Abstract Benign multiple sclerosis (MS), traditionally defined as Expanded Disability Status Scale (EDSS) score ?3 and ?15-year disease duration, is thought to follow a milder clinical course. We determined the extent of visual pathway axonal loss by optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) thickness in a benign MS cohort and examined the relation to vision and quality of life (QOL). In this longitudinal study of vision in MS at 3 academic centers, a subset of patients with EDSS, visual function, OCT, and QOL assessments was analyzed. Low- and high-contrast letter acuity was performed to assess visual function. RNFL thickness was determined using time-domain OCT. QOL scales included the 25-Item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) and Short Form-36 Health Survey. Among 68 patients (135 eyes) studied longitudinally, 13 (26 eyes) had benign MS using criteria of EDSS score ?3 and ?15-year disease duration. Benign MS eyes had as much RNFL thinning (-3.6 ?m, P = 0.0008 vs baseline, paired t test) as typical MS eyes (-3.3 ?m, P < 0.0001). Both groups had significant low-contrast acuity loss. History of optic neuritis (ON) was more frequent in benign MS (69% vs 33% of eyes). History of ON distinguished benign vs typical MS (P = 0.002) and correlated with RNFL thickness at baseline (P = 0.002) and disease duration (P = 0.03) but not EDSS (P = 0.32, logistic regression). NEI-VFQ-25 scores were also worse for benign MS, accounting for age (75 - 21 vs 88 - 11, P = 0.005). Patients with benign MS have RNFL axonal loss that is as marked as that of typical MS and have reduced vision and QOL. While overall neurologic impairment is mild, visual dysfunction, not well captured by the EDSS, accounts for a substantial degree of disability in benign MS.
Subject Female; Follow-Up Studies; Humans; Male; Middle Older people; Multiple Sclerosis; Prospective Studies; Quality of Life; Questionnaires; Retinal Ganglion Cells; Tomography, Optical Coherence; Visual Acuity; Visual Pathways
OCR Text Show
Format application/pdf
Publication Type Journal Article
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
Setname ehsl_novel_jno
ID 227297
Reference URL https://collections.lib.utah.edu/ark:/87278/s65m9bs4/227297
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