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Multiple Sclerosis l: Introduction01:19

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Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...

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Static and dynamic pupillary characteristics in multiple sclerosis.

Ersin Muhafiz1, Erdinç Bozkurt1, Can Emre Erdoğan2

  • 1Ophthalmology Department, Kafkas University Faculty of Medicine, Kars, Turkey.

European Journal of Ophthalmology
|September 8, 2021
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Pupillary functions in multiple sclerosis (MS) patients with normal vision may be altered. Mesopic and photopic pupillary responses are impaired, while scotopic functions remain intact.

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Area of Science:

  • Ophthalmology
  • Neurology
  • Medical Imaging

Background:

  • Multiple sclerosis (MS) can affect visual pathways, even in patients with preserved visual acuity.
  • Automated pupillography offers a sensitive method to assess subtle neurological impacts on ocular function.

Purpose of the Study:

  • To investigate static and dynamic pupillary responses using automated pupillography in multiple sclerosis patients with preserved visual acuity.
  • To compare pupillary function between MS patients and healthy controls.

Main Methods:

  • Included 47 MS patients and 43 healthy controls with preserved visual acuity.
  • Assessed visual evoked potential, contrast sensitivity, and retinal nerve fiber layer (RNFL) thickness.
  • Performed static (scotopic, mesopic, photopic) and dynamic pupillography to measure pupil diameter and dilation speed.

Main Results:

  • MS patients showed significantly lower contrast sensitivity and RNFL thickness compared to controls.
  • Mesopic and photopic pupil diameters were significantly smaller in MS patients (p=0.044 and p=0.004, respectively).
  • Dynamic pupillography revealed greater pupil dilation in MS patients at most time points, with faster initial dilation speed (p=0.044).

Conclusions:

  • Static and dynamic pupillary functions may be affected in MS patients, even with preserved visual acuity.
  • Mesopic and photopic pupillary functions appear weakened in MS, whereas scotopic functions are preserved.
  • Pupillary abnormalities may serve as an indicator of subclinical visual pathway involvement in MS.