Visual loss in multiple sclerosis and its relation to previous optic neuritis, disease duration and clinical...

Visual function was investigated in a group of 58 clinically classified cases of multiple sclerosis (MS). Psychophysical measures of luminance and chromatic threshold sensitivity and temporal contrast sensitivity were undertaken, together with visual evoked potentials and Bjerrum screen perimetry. The patient group was divided on the basis of optic neuritis (ON), clinical disease duration and clinical classification. A comparison of the results of all visual measures suggested a nonuniform loss of function in the patient group without ON and a more consistent loss of function in the group with ON. The various measures were equally efficient in detecting abnormal function, albeit from different areas of the central visual field. Clinical disease duration was not a significant independent factor in predicting visual dysfunction. In contrast, a comparison of clinical classification categories revealed significantly fewer abnormalities of visual function in the suspected MS category (31%) than in the ON, early probably and clinically definite categories (75-100%), a result which indicated the importance of clinical classification as a predictor of visual dysfunction.