Advances in Vision Assessment in Multiple Sclerosis

September 11, 2014 Eugene F. May

Over the past several years, the visual function of people living with multiple sclerosis (MS) has been increasingly recognized as an important marker of quality of life in MS, and as a useful indicator of the severity and activity of MS both clinically, and in MS research. Measurement of a person’s ability to see faded letters (low contrast acuity) has been found to be an excellent marker of MS visual function, and its change over time is related to MS disease activity. Optical coherence tomography (OCT), which measures the health of optic nerves and retinas in individuals with MS, is providing an explosion of data that has increased our insight into the extent, course, and pathology of multiple sclerosis.
At this year’s North American Neuro-ophthalmology Society meeting, data was presented on another technique that is being developed and refined for use in the MS population, a questionnaire about visual quality of life.  The “Neuro-ophthalmic supplement to the NEI-VFQ-25” is a ten-question survey that has been designed to determine the visual quality of life in people with MS and other neurologic disorders. Data so far show that the survey is effective at distinguishing people with MS from people with no neurologic conditions, implying that the survey is sensitive to the visual problems that develop in people with MS. In addition, the survey was shown to be able to distinguish people with MS who had had optic neuritis (an MS relapse involving the optic nerve) compared to those who had never had optic neuritis. The survey score also correlated with health of the optic nerves, as determined by OCT. These findings suggest that the survey will be sensitive to visual problems that change in MS over time, either due to optic neuritis or progression.
Low-contrast acuity testing and OCT are currently available to people with MS at our MS Eye Clinic. We will consider adding the NEI-VFQ-25 with the Neuro-ophthalmic supplement, as more data is available.

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