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Rachel McKay, Marianne Piano, Peter Bex, Jennifer Preston, Ben Stansfield, Anita Simmers; Persistent Visual Impairment in Multiple Sclerosis: Prevalence and functional consequences.. Journal of Vision 2018;18(10):39. doi: https://doi.org/10.1167/18.10.39.
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Impaired visual function is a concern for up to 80% of people who have received a diagnosis of multiple sclerosis (Balcer 2015), and may result from involvement of structures in the afferent visual pathways, ocular motor systems or from cerebral deficits. Although visual symptoms in pwMS may precede, occur simultaneously with, or follow the development of other neurologic manifestations, they may represent the most prominent symptoms from the person living with MS's point of view. In a mixed methods study 110 participants completed a series of quality of life questionnaires (VFQ-25 with 10item neurological add-on, MSIS-29) and a full visual (HCVA, Contrast Sensitivity Function – spatial and temporal, ocular alignment and motility, colour vision, confrontational visual fields, stereoacuity and Pulfrich's) and functional assessment using the Multiple Sclerosis Functional Composite and the King-Devick Test. A small subgroup (n=10) undertook a further assessment of visual fields, motion coherence, OCT and balance using the Biosway Portable Balance Test. In Stage One pwMS reported greater persistent visual dysfunction impacting on daily life when compared with a non-MS, eye disease free population. Clinical assessment in Stage Two found that while visual deficits previously reported as cause for concern in pwMS – high contrast acuity, visual fields, colour and binocular vision did not appear to affect pwMS longitudinally, contrast sensitivity function was a significant cause of persistent visual loss impacting on daily life in pwMS. In Stage Three motion coherence was also found to be impaired causing difficulties with daily life. The study findings demonstrate a significant loss in visual perception in pwMS when testing in both the temporal and spatial domain. These persistent visual losses correlated with self-reported visual function and functional assessment having implications for guiding future rehabilitation strategies.
Meeting abstract presented at VSS 2018
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