Visual field impairment captures disease burden in multiple sclerosis.

Area of Science:

• Neurology
• Ophthalmology
• Neuroimmunology

Background:

• Monitoring disease burden in multiple sclerosis (MS) is crucial for clinical decision-making.
• Identifying patients at high risk of disability progression is an unmet need.

Purpose of the Study:

• To assess the utility of visual field testing in non-optic neuritis eyes (non-ON eyes) as a biomarker for MS disability progression.
• To correlate visual field abnormalities with established markers of neuroaxonal injury and disability.

Main Methods:

• The MS-VisualPath cohort included 109 MS patients.
• Linear regression models analyzed associations between visual field defects and global/cognitive disability, and brain/retinal imaging markers.
• Risk of disability progression was evaluated over a 3-year follow-up period.

Main Results:

• 62% of patients exhibited visual field defects in non-ON eyes.
• Visual field mean deviation correlated with global disability and neuroaxonal damage markers (brain parenchymal volume, gray matter volume, lesion load, retinal nerve fiber layer thickness, macular ganglion cell complex thickness).
• Patients with baseline visual field impairment had significantly greater disability and neuroaxonal damage.

Conclusions:

• Impaired visual fields in non-ON eyes are associated with increased disability and neuroaxonal injury in MS.
• Baseline visual field impairment triples the risk of disability progression over 3 years.
• Visual field testing shows promise as a tool for monitoring MS disease burden.