Prevalence of Ophthalmological Manifestations of MS

Abstract Objective The aim of this study is to highlight the neuro-ophthalmic manifestations and their correlation with visual dysfunction in patients of multiple sclerosis (MS). Patients and Methods One hundred patients diagnosed with MS according to the Revised McDonald’s Criteria of 2010 from the MS Unit at Ain Shams University Hospitals were included in the study from May to September 2017. A detailed medical history was taken and full ophthalmic examination was done to all patients including best corrected visual acuity (BCVA), pupillary reflexes, ocular motility, confrontation test, contrast sensitivity (CS) test, color test, slit-lamp biomicroscopy and dilated fundus examination. Results Acute ON was the first manifestation of the disease in 36% of patients and in 44% it occurred during the course of the disease. Although most patients’ visual acuity recovered to baseline after an episode of optic neuritis (ON), residual deficits in CS are common. Acute ocular motor manifestations were reported in 6 patients (6%) as a presenting symptom of MS. During the course of the disease 31 patients (31%) had at least one attack of acute abnormal eye movement. One patient (1%) among the studied group had anterior uveitis. There is a statistically significant correlation between CS in patients with no ON relapses and patients with at least 1 relapse (P value= 0.005). There is a statistically significant correlation between relative afferent pupillary defect (RAPD) in patients with no ON attacks and patients with at least 1 relapse (P value= 0.032). Also there is a statistically significant correlation between disc pallor in patients with no ON relapses and patients with at least 1 relapse (P value= 0.007). There is a statistically significant correlation between number of relapses of ocular motor symptoms and visual function impairment; BCVA (P = 0.025), CS (P = 0.027) and color vision (P = 0.039). Conclusion Our study emphasizes the high prevalence of ophthalmic manifestations among MS patients and that optic neuropathy is the most common manifestation. Detection of these symptoms and signs during ophthalmologic evaluation may lead to early diagnosis and treatment of MS that offer better outcome for those patients.