Impairment of contrast visual acuity as a functional correlate of retinal nerve fibre layer thinning and total macular volume reduction in multiple sclerosis

Item Type:	Article
Title:	Impairment of contrast visual acuity as a functional correlate of retinal nerve fibre layer thinning and total macular volume reduction in multiple sclerosis
Creators Name:	Bock, M. and Brandt, A.U. and Kuchenbecker, J. and Doerr, J. and Pfueller, C.F. and Weinges-Evers, N. and Gaede, G. and Zimmermann, H. and Bellmann-Strobl, J. and Ohlraun, S. and Zipp, F. and Paul, F.
Abstract:	Objectives: To analyse the association between retinal nerve fibre layer thickness (RNFLT) and total macular volume (TMV) as measured by optical coherence tomography, and contrast sensitivity (CS) measured by Functional Acuity Contrast Testing (FACT) in relapsing-remitting multiple sclerosis; and to investigate whether FACT testing by a contrast box device is feasible in multiple sclerosis (MS). Methods: FACT was performed using the Optec 6500 P vision testing system with best correction under photopic and mesopic conditions without glare. The Area Under the Log Contrast Sensitivity Function (AUC) was calculated. RNFLT and TMV were assessed by Stratus optical coherence tomography. All participants underwent visual acuity testing (Snellen), spherical refractive error testing and cylindrical refractive error testing. Results: 85 relapsing-remitting multiple sclerosis patients (170 eyes) and 35 healthy controls (HC, 70 eyes) were measured. AUC Day and Night were lower in MS than in HC (p<0.001) when correcting for age, as were mean RNFLT and TMV (p<0.001 and p=0.018, respectively). Both RNFLT and TMV predicted contrast sensitivity in MS (AUC Day: standardised coefficient beta=0.277, p<0.001, and beta=0.262, p<0.001, respectively; AUC Night: beta=0.202, p=0.009 and beta=0.222, p=0.004, respectively, linear regressions). In HC, there was no correlation between RNFLT or TMV and contrast sensitivity. Conclusion: (1) Contrast sensitivity is reduced in MS versus HC; (2) RNFL and TMV as morphological measures of retinal axonal loss are predictors of contrast sensitivity as a functional visual parameter in MS but not in HC; and (3) FACT with the contrast box is a novel, feasible and rapid method to assess contrast sensitivity in MS.
Keywords:	Contrast Sensitivity, Cross-Sectional Studies, Linear Models, Macula Lutea, Multiple Sclerosis, Relapsing-Remitting, Nerve Fibers, Predictive Value of Tests, Severity of Illness Index, Optical Coherence Tomography, Vision Disorders, Visual Acuity
Source:	British Journal of Ophthalmology
ISSN:	0007-1161
Publisher:	British Medical Association
Volume:	96
Number:	1
Page Range:	62-67
Date:	January 2012
Official Publication:	https://doi.org/10.1136/bjo.2010.193581
PubMed:	View item in PubMed

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