Persistent Visual Loss in Multiple Sclerosis: Predictive Factors

[摘要] Background: Optic nerve is frequently involved in multiple sclerosis and optic neuritis (ON) is one of the commonest presenting features of MS. Objective: To investigate cases of optic neuritis in multiple sclerosis (MS) patients who did not recover visual acuity and to find a relation with their expanded disability status scale (EDSS), their MRI findings and onset of treatment. Methods: This is a retrospective study of 25 patients with RRMS and SPMS with history of acute optic neuritis whose visual acuity was not recovered and we compared them with 26 MS patients who recovered their visual acuity. Their data were collected from their records including history of MS illness and history of treatment received, full ophthalmologic examination, visual field testing, full neurological examination and EDSS and MRI FALIR scans with recording of number and location of demyelinating plaques before, during, one month and six months following the attack of optic neuritis. Results: Relative delay in initiation of treatment was recorded in 17 cases of group A. The visual acuity ranged from 0.7 to 1/60, reduction in mean deviation and increase in loss variance were significant in the first month and stabilized over the next five months in group A. The higher EDSS scores and delayed treatment carried worse prognosis with incomplete recovery. Conclusion: Recovery of visual function to almost normal level is the rule in optic neuritis in MS, however, there are predictive factors that proved to be of value in patients who did not recover visual function as delay in starting treatment and increase EDSS scores. These determinants will help in the prognosis of visual recovery in MS patients developing optic neuritis. (Egypt J Neurol Psychiat Neurosurg. 2010; 47(1): 43-48)

[学科分类] 精神健康和精神病学