This population study retrospectively identified patients with multiple sclerosis (MS) over a 14-year period. The aim of the study was to report the frequency and severity of ocular conditions associated with MS. Cases were identified from the Rochester Epidemiology Project. The following data were extracted from medical records: demographics, medical history, ophthalmic and neurological symptoms, neuroimaging, serum and cerebrospinal fluid studies. Cases were excluded if other demyelinating conditions were identified. A total of 116 cases were included in the study; 34% were male with a median age of 36 years and the majority were Caucasian. Of these 53% reported ocular symptoms at any time point, 28% had an ocular symptom as a presenting symptom. The most common ophthalmic diagnosis was optic neuritis on presentation (22%) and at any time point (37%). Other ocular diagnoses at any time point included internuclear ophthalmoplegia (16%), nystagmus (13%), skew deviation (3%), saccadic defect (3%), cranial nerve palsy (2%) and homonymous hemianopia (1%). In 30% of cases, multiple ocular defects occurred simultaneously. Of those with optic neuritis, 21% experienced recurrent attacks. The authors acknowledge the retrospective methodology, missing data and ethnic homogeneity as limitations of the study. This study continues to highlight the importance of collaboration between neurology and eyecare teams in MS to provide high-quality care.
Multiple sclerosis and the ocular manifestations
Reviewed by Lauren Hepworth
Ocular manifestations of multiple sclerosis: a population based study.
CONTRIBUTOR
Lauren R Hepworth
University of Liverpool; Honorary Stroke Specialist Clinical Orthoptist, Northern Care Alliance NHS Foundation Trust; St Helen’s and Knowsley NHS Foundation Trust, UK.
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