Visual field impairment captures disease burden in multiple sclerosis

被引:14
作者
Ortiz-Perez, Santiago [2 ]
Andorra, Magi [1 ]
Sanchez-Dalmau, Bernardo [2 ]
Torres-Torres, Ruben [2 ]
Calbet, David [3 ]
Lampert, Erika J. [1 ]
Alba-Arbalat, Salut [1 ]
Guerrero-Zamora, Ana M. [1 ]
Zubizarreta, Irati [1 ]
Sola-Valls, Nuria [1 ]
Llufriu, Sara [1 ]
Sepulveda, Maria [1 ]
Saiz, Albert [1 ]
Villoslada, Pablo [1 ]
Martinez-Lapiscina, Elena H. [1 ]
机构
[1] Univ Barcelona, Hosp Clin Barcelona, Inst Invest Biomed August Pi Sunyer IDIBAPS, Dept Neurol,Ctr Neuroimmunol, Villarroel 170, ES-08036 Barcelona, Spain
[2] Univ Barcelona, Hosp Clin Barcelona, Inst Invest Biomed August Pi Sunyer IDIBAPS, Dept Ophthalmol, Villarroel 170, ES-08036 Barcelona, Spain
[3] Invest Estadist SL, Barcelona, Spain
关键词
Multiple sclerosis; Neurodegeneration; Brain atrophy; Disability progression; Visual fields; Perimetry; STANDARD AUTOMATED PERIMETRY; OPTICAL COHERENCE TOMOGRAPHY; COLOR-VISION IMPAIRMENT; CONTRAST LETTER ACUITY; QUALITY-OF-LIFE; PATHWAY; DYSFUNCTION; NEURITIS; ABNORMALITIES; DISABILITY;
D O I
10.1007/s00415-016-8034-2
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Monitoring disease burden is an unmeet need in multiple sclerosis (MS). Identifying patients at high risk of disability progression will be useful for improving clinical-therapeutic decisions in clinical routine. To evaluate the role of visual field testing in non-optic neuritis eyes (non-ON eyes) as a biomarker of disability progression in MS. In 109 patients of the MS-VisualPath cohort, we evaluated the association between visual field abnormalities and global and cognitive disability markers and brain and retinal imaging markers of neuroaxonal injury using linear regression models adjusted for sex, age, disease duration and use of disease-modifying therapies. We evaluated the risk of disability progression associated to have baseline impaired visual field after 3 years of follow-up. Sixty-two percent of patients showed visual field defects in non-ON eyes. Visual field mean deviation was statistically associated with global disability; brain (normalized brain parenchymal, gray matter volume and lesion load) and retinal (peripapillary retinal nerve fiber layer thickness and macular ganglion cell complex thickness) markers of neuroaxonal damage. Patients with impaired visual field had statistically significative greater disability, lower normalized brain parenchymal volume and higher lesion volume than patients with normal visual field testing. MS patients with baseline impaired VF tripled the risk of disability progression during follow-up [OR = 3.35; 95 % CI (1.10-10.19); p = 0.033]. The association of visual field impairment with greater disability and neuroaxonal injury and higher risk of disability progression suggest that VF could be used to monitor MS disease burden.
引用
收藏
页码:695 / 702
页数:8
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