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    You are here : Home » MS Research News » Optical Assessments and MS Research

    Optical Assessments and MS Research

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    More news can be found in New Pathways Magazine, our bi-monthly publication, and also check daily at MSRC: Latest MS News.

    Recurring optic neuropathy in patients with MS may lead to thinning of RNFL
    EyeOptical coherence tomography may be a useful tool for evaluating and classifying patients with multiple sclerosis, according to a study.

    Imaging the retinal architecture, and the retinal nerve fiber layer in particular, appears to correlate with clinical phenotype. "We observed lower [retinal nerve fiber layer] values in progressive MS subtypes relative to patients with less advanced disease," the study authors said.

    The investigators noted worse visual function among patients with MS and optic neuropathy, a common comorbidity of the systemic disease. That finding may be due to repeat inflammatory events that damage axonal visual pathways, according to the study.

    Retinal nerve fiber layer (RNFL) values were reduced in eyes with primary progressive MS (94.3 µm), relapsing-remitting MS (99.6 µm) and secondary progressive MS (84.7 µm) compared with eyes of patients with optic neuropathy as a clinically isolated syndrome (105.7 µm).

    Because patients with secondary progressive MS are known to have a longer duration of disease, they may also have greater risk for recurrent optic neuropathy, which may, in turn, lead to continual thinning of the RNFL, the investigators said.

    According to the study, a simple linear regression model showed that visual field sensitivity decreased 5.8 decibels with every 10 µm regression in RNFL value

    Source: OSN Supersite Copyright © 2010 SLACK Inc (14/10/10)

    Simple eye test measures damage from multiple sclerosis

    MS Eye TestA quick, painless eye measurement shows promise as a way to diagnose multiple sclerosis in its very early stages, and to track the effectiveness of treatments, researchers from UT Southwestern Medical Center have found in a multicenter study.

    "This technique has the potential to provide a powerful and reliable assessment strategy to measure structural changes in the central nervous system, both for diagnostic purposes and in clinical trials to monitor whether potential treatments can prevent deterioration or restore nerve function," said Dr. Elliot Frohman, professor of neurology and ophthalmology, director of the Multiple Sclerosis Clinical Center at UT Southwestern and co-senior author of the study, which appears in the June issue of Annals of Neurology.

    The technique, called optical coherence tomography (OCT), reliably measures thinning of the retina in people with multiple sclerosis, the researchers found.

    "An ophthalmologist might someday be able to use OCT to identify retinal thinning during a routine eye exam and consider MS as a prime diagnosis," Dr. Frohman said. "However, this prospect is a long way off."

    The retina, which lines the back of the eye, detects light and sends visual information to the brain via the optic nerve. Retinal thinning can occur as a result of multiple sclerosis, but this study, Dr. Frohman said, is the first to track such thinning over time in a single group of patients. The Neurology study involved 299 patients with MS who were tracked for six months to 4.5 years.

    The researchers found that the retinas thinned significantly with time, and patients often concurrently lost visual sharpness. Overall, the study indicated that OCT is reliable, easy to use and sensitive to changes over time. It could also be used with current clinical measures, the researchers said.

    Because the retina is easily visible through the pupil, it provides a convenient route for assessing nerve damage, compared with other parts of the body. As a result, retinal measurement might be able to pick up signs of multiple sclerosis before a person develops other symptoms, Dr. Frohman said.

    OCT machines already are available. Patients look into a device similar to those that measure vision for corrective lenses. Near-infrared light, which is invisible to the eye, penetrates the retina and provides information on its thickness. The measurement takes a few seconds for each eye.

    In addition to the OCT testing, patients in the latest study looked at eye charts so the researchers could test their vision. Control subjects came from the patients' families and clinics' staff.

    Future studies are needed to ascertain whether OCT can characterize the effectiveness of treatments, Dr. Frohman said.

    Source: UT Southwestern Medical Center (08/06/10)

    Evaluating loss of visual function in multiple sclerosis as measured by low-contrast letter acuity

    EyeBackground: Disturbances in visual function are common in patients with multiple sclerosis (MS) and are often accompanied by substantial impairments in daily functioning and quality of life.

    Lesions associated with these impairments frequently involve the afferent visual pathway.

    Expert Clinical Opinion: Because these impairments are often not readily apparent on commonly used high-contrast acuity tests, low-contrast charts (e.g., low-contrast Sloan letter charts) have gained validity in the assessment of visual dysfunction in patients with MS. Decrements in low-contrast letter acuity are associated with MS and correlate with increasing disability, MRI abnormalities, and reduced retinal nerve fiber layer (RNFL) thickness as measured by optical coherence tomography (OCT).

    These findings suggest that low-contrast letter acuity testing is a potentially useful addition to disability scales such as the Multiple Sclerosis Functional Composite, serving as another surrogate marker for MS disability. Assessment of RNFL thickness by OCT, which is also associated with visual impairment, also may be considered for inclusion in clinical trials evaluating treatments for MS.

    Future Directions: The effects of disease-modifying therapies on visual dysfunction in patients with MS have been evaluated only recently. Two phase 3 studies of natalizumab showed that low-contrast letter acuity testing, included as an exploratory outcome, demonstrated treatment effects.

    Other ongoing studies have incorporated low-contrast acuity and OCT measures of RNFL thickness. The availability and wider use of low-contrast letter acuity tests, in combination with ocular imaging techniques, may improve assessment of treatment efficacy in patients with MS.

    Laura J. Balcer, MD, MSCE and Elliot M. Frohman, MD, PhD

    From the Departments of Neurology, Ophthalmology, and Epidemiology (L.B.), University of Pennsylvania School of Medicine, Philadelphia; and Departments of Neurology and Ophthalmology (E.F.), University of Texas Southwestern Medical Center at Dallas, Dallas.

    Source: NEUROLOGY 2010;74:S16-S23 © 2010 American Academy of Neurology (17/05/10)

    The relationship between visual field and retinal nerve fiber layer measurements in patients with multiple sclerosis
    A new study, 'The relationship between visual field and retinal nerve fiber layer measurements in patients with multiple sclerosis,' is now available.

    In this recent report, researchers in the United States conducted a study "To investigate the relationship between visual function, measured by standard automated perimetry (SAP), and retinal nerve fiber layer (RNFL) thickness, measured by optical coherence tomography (OCT), in patients with multiple sclerosis (MS). SAP and RNFL thickness were measured in patients with MS in 28 eyes with the last optic neuritis (ON) >or=6 months prior (ON group) and 33 eyes without ON history (non-ON group)."

    "Abnormal overall or quadrant RNFL thickness was defined by measured values below 5% of the norm. A whole visual field or a sector of the field was classified as abnormal by using cluster criteria on total-deviation plots. Agreement between SAP and OCT results in classifying eyes/sectors was presented as a percentage of observed agreement, along with the AC1 statistic, which corrects for chance agreement. Regression analyses were performed relating several SAP parameters and RNFL thickness in the ON group. ON eyes showed more loss of visual sensitivity (MD, p=0.02) and more loss of RNFL thickness (p <0.0001) than did non-ON eyes. SAP and OCT agreed in 86% (AC1=0.78) of eyes and 69% (AC1=0.38) of sectors in the ON group and 61% (AC1=0.33) of eyes and 66% (AC1=0.48) of sectors in the non-ON group. Overall RNFL thickness was related to MD (dB) by a simple exponential function (R(2)=0.48), supporting a linear relationship between these measures when both are expressed on linear scales. Absolute Pearson correlation coefficients for overall RNFL thickness and several SAP parameters ranged from 0.51 to 0.69. Good agreement between SAP and OCT was found in ON eyes but not in non-ON eyes or in individual sectors in either group," wrote H. Cheng and colleagues, University of Houston, College of Optometry.

    The researchers concluded: "The findings in this study provide further support for the utility of combining structural and functional testing in clinical research on patients with MS, as well as in future neuroprotection trials for which the anterior visual pathways in patients with MS and optic neuritis may be used as a model."

    Cheng and colleagues published their study in Investigative Ophthalmology & Visual Science (The relationship between visual field and retinal nerve fiber layer measurements in patients with multiple sclerosis. Investigative Ophthalmology & Visual Science, 2007;48(12):5798-805).

    Source: NewsRX Copyright © 2008 NewsRx (30/01/08)

    Eye centre detecting MS in early stages
    Doctors in Houston are looking into their patients` eyes to search for early signs of multiple sclerosis.

    Using four different and inexpensive eye exams, physicians at the Multiple Sclerosis Eye Centre for Analysis, Research and Education search for abnormalities in the retina and damage to optic nerve fibres. Many doctors agree that, in more than half of patients, the neurological disorder first attacks the eyes, causing blurred vision, and temporary or permanent sight loss, the Wall Street Journal said Tuesday, 02 January 2007.

    By concentrating on the eyes, 'the centre is helping patients identify irregularities and referring them for treatments that may slow the disorder`s progression,' says Rosa Tang, co-director at MS Eye Care.

    No one test can either diagnose or eliminate MS, doctors said. Several tests, such as an MRI or a spinal tap, both expensive, are needed for a thorough diagnosis.

    A number of doctors are pushing for more centres similar to MS Eye Care, based on its capability of early detection at a lower cost.

    Source UPI Copyright 2007 by United Press International

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