Evolutionary Neuro-Ophthalmological Evaluation in Patients with Multiple Sclerosis
Keywords:
multiple sclerosis; neuro-ophthalmological study; contrast sensitivityAbstract
Objective: To evaluate the evolution of retinal and optic nerve ophthalmological manifestations in Multiple Sclerosis.
Methods: A prospective descriptive longitudinal study was carried out in a series of patients with MS, referred to the Neuro-ophthalmology clinic of the “Hermanos Ameijeiras” Hospital in the period from June 2021 to September 2022.
Results: The average age value was 43.1 years, with a predominance of the female sex (76.3 %). The predominant clinical form was relapsing remitting (76.3 %). The psychophysical studies (BVA, CV, VC) were normal in most cases except for contrast sensitivity (CS), detecting a significant decrease in the average values in the annual evolutionary study, especially in the cases with greater clinical severity of the disease. The OCT showed a decrease in the ganglion cell layer (OD.42.1 and OI.44.7 %) and RNFL (26.3 % in AO).
Conclusions: In the series studied, women in the fourth decade of life with Relapsing-Remitting Multiple Sclerosis predominated. The annual evolutionary follow-up of the neuro-ophthalmological manifestations in patients with Multiple Sclerosis behaved in a stable manner, not detecting changes in the psychophysical studies and diagnostic means except for the significant decrease in contrast sensitivity, especially in the most severe cases. clinic of the disease and longer evolution time.
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1. Llaneza M, Meca J, Gonzalez M. Oreja-Guevara C. Recomendaciones diagnóstico-terapéuticas de la SEN 2023. Manual de práctica clínica en esclerosis múltiple, NMO y MOGAD. Sociedad Española de Neurología; 2023 [acesso 20/05/2023]. Disponible en: https://www.sen.es/pdf/2023/GuiaEsclerosis_2023web.pdf
2. Nunes JC, Radbruch H, Walz R, Lin K, Stenzel W, Prokop S, et al. The most fulminant course of the Marburg variant of multiple sclerosis-autopsy findings. Mult Scler. 2015;21(4):485-7. DOI: https://doi.org/10.1177/1352458514537366
3. Fernández Ó, Sörensen PS, Comi G, Vermersch P, Hartung HP, Leocani L, et al. Managing multiple sclerosis in individuals aged 55 and above: a comprehensive review. Front Immunol. 2024;15:1379538. DOI: https://doi.org/10.3389/fimmu.2024.1379538
4. Cabrera A y Manero R. Algunas consideraciones sobre esclerosis múltiple en Latinoamérica. Primera estadística presentada en Cuba. Estudio comparativo. Revista Cubana de Medicina. 1975 [acesso 20/05/2023];14(4):487-504. Disponible en: https://revmedicina.sld.cu/index.php/med/article/view/948.
5. Rojas E, Alva A, Montalvan V. Cambios clínicos de la esclerosis múltiple según modificación de los criterios de Mc Donald. 2015. An Fac Med. 2019;80(1):34-8. DOI: https://doi.org/10.15381/anales.v80i1.15867
6. González Gómez A, García-Ben A, Soler García A, García-Basterra I, Padilla Parrado F, García-Campos JM. Longitudinal study of visual function in patients with relapsing-remitting multiple sclerosis with and without a history of optic neuritis. Neurologia (Engl Ed). 2019;34(4):241-7. DOI: https://doi.org/10.1016/j.nrl.2017.01.003
7. Katz Sand IB, Lublin FD. Diagnosis and differential diagnosis of multiple sclerosis. Continuum (Minneap Minn). 2013;19(4 Multiple Sclerosis):922-43. DOI: https://doi.org/10.1212/01.CON.0000433290.15468.21
8. Olek MJ, Howard J. Evaluation and diagnosis of multiple sclerosis in adults. In: F. González-Scarano (ed.). UpToDate. Wolters Kluwer; 2019 [acceso 11/05/2023]. Disponible en: https://touroscholar.touro.edu/faculty_pubs/430/
9. Portaccio E, Betti M, De Meo, E. Progression independent of relapse activity in relapsing multiple sclerosis: impact and relationship with secondary progression. J Neurol. 2024;271. DOI: https://doi.org/10.1007/s00415-024-12448-4
10. Oreja C, Quezada-Sánchez J. Multiple Sclerosis. Analysis of Visual Acuity, Contrast Sensitivity and Color Perception in Multiple Sclerosis Patients. Multiple Sclerosis and Related Disorders. 2022;59. DOI: https://doi.org/10.1016/j.msard.2022.103597
11. Soler A. Relación entre el test de sensibilidad al contraste y el nivel de gravedad en pacientes con esclerosis múltiple. Archivos de la Sociedad Española de Oftalmología. 2014 [acceso 10/05/2023];89(9):347-51. Disponible en: https://www.fundacionlilly.com/impulso-medicina/medes
12. Soler A, Padilla F, Figueroa-Ortiz L, González A, García-Ben A, García-Ben E, et al. Análisis del grosor macular y de capa de fibras nerviosas en pacientes con esclerosis múltiple en relación con su nivel de gravedad y antecedentes previos de neuritis óptica. Neurología. 2016 [acceso 15/05/2023];31(6):379-88. Disponible en https://dialnet.unirioja.es/servlet/articulo?codigo=5584443
13. Ossa-Calderón C. Utilidad diagnóstica de la tomografía de coherencia óptica en pacientes con neuritis óptica desmielinizante. Rev Mex Oftalmol. 2019 [acceso 20/05/2023];93(2):69-74. Disponible en; https://www.scielo.org.mx/scielo.php
14. Petzold A, Balcer L, Calabresi P, Costello F, Frohman T, Frohman E, et al. Retinal Layer Segmentation in Multiple Sclerosis: a Systematic Review and Meta-Analysis. Lancet Neurol. 2017;16(10):797-812. DOI: https://doi.org/10.1016/s1474-4422(17)30278-8
15. Mirmosayyeb O, Zivadinov R, Weinstock-Guttman B, Benedict R, Jakimovski D. Optical Coherence Tomography (OCT) Measurements and Cognitive Performance in Multiple Sclerosis: a Systematic Review and Meta-Analysis. J Neurol. 2023;270(3):1266-85. DOI: https://doi.org/ 10.1007/s00415-022-11449-5
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