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Contrast sensitivity in multiple sclerosis. A study in 35 patients with and without optic neuritis
J P Nordmann1, H Saraux, E Roullet
1Service d'Ophtalmologie, Hôpital Saint-Antoine, Paris, France.
Summary
Contrast sensitivity (CS) is often impaired in multiple sclerosis (MS) patients, affecting both eyes even without a history of optic neuritis. This measure can detect subtle visual pathway damage in MS, outperforming visual evoked potentials.
Area of Science:
- Neuroscience
- Ophthalmology
- Neurology
Background:
- Multiple sclerosis (MS) is a demyelinating disease affecting the central nervous system.
- Visual pathway involvement is common in MS, often leading to optic neuritis.
- Contrast sensitivity (CS) is a visual function that may be affected in MS.
Purpose of the Study:
- To determine binocular and monocular contrast sensitivity (CS) functions in patients with multiple sclerosis (MS).
- To assess the utility of CS in detecting visual pathway involvement in MS, including subclinical cases.
Main Methods:
- Contrast sensitivity functions were measured in 35 MS patients.
- Patients were categorized based on a history of optic neuritis.
- Data were analyzed to compare CS between affected and unaffected eyes and across spatial frequencies.
Main Results:
- All 21 MS patients with a history of optic neuritis showed abnormal CS.
- CS deficits were observed across all spatial frequencies in both affected and clinically unaffected eyes (p < 0.01).
- Approximately one-third of MS patients without a history of visual disturbances had evidence of optic nerve involvement.
Conclusions:
- Clinically apparent visual impairment in MS is often bilateral, irrespective of unilateral optic neuritis.
- Contrast sensitivity testing is a sensitive method for detecting 'silent' lesions in the visual pathways of MS patients.
- CS may be a more sensitive indicator of visual pathway damage in MS than visual evoked potentials.