Disorders of vision in multiple sclerosis.

Area of Science:

• Neurology
• Ophthalmology
• Immunology

Background:

• Multiple sclerosis (MS) is a central nervous system inflammatory disease targeting myelinated areas.
• Visual pathway involvement is common in MS, affecting optic nerves, retina, and occipital cortex.
• Understanding visual manifestations is crucial for MS diagnosis and management.

Purpose of the Study:

• To review clinical presentations and diagnostic methods for MS-related visual disorders.
• To discuss differential diagnoses for optic neuropathies.
• To examine the impact of MS treatments on vision.

Main Methods:

• Literature review of clinical manifestations, diagnostic imaging, and treatment effects in MS and related disorders.
• Analysis of diagnostic tools including optical coherence tomography (OCT) and magnetic resonance imaging (MRI).
• Comparison of visual symptoms in MS with other optic neuropathies like neuromyelitis optica spectrum disorder.

Main Results:

• MS commonly causes optic neuritis, characterized by unilateral vision loss and pain on eye movement.
• MRI is vital for MS diagnosis and disability prediction; OCT detects subclinical optic nerve damage.
• MS can lead to gaze abnormalities and internuclear ophthalmoplegia due to brainstem lesions.
• MS treatments, including corticosteroids and fingolimod, can cause visual side effects like retinopathy and macular edema.

Conclusions:

• Comprehensive visual assessment is essential in managing MS patients.
• Distinguishing MS from other optic neuropathies is critical for appropriate treatment.
• Awareness of treatment-related visual side effects is necessary for patient safety.