Barriers to care for people with unclear visual loss - data from a tertiary-level-of-care neuroinflammation center

Delikaya, Murat; Bereuter, Charlotte; Schroeter, Jan; Nowak, Elisa; Dorsch, Eva-Maria; Kilinska, Lidia; Kuchling, Joseph; Siebert, Nadja; Behrens, Janina; Paul, Friedemann; Bellmann-Strobl, Judith; Schmitz-Hübsch, Tanja; Oertel, Frederike Cosima

Barriers to care for people with unclear visual loss - data from a tertiary-level-of-care neuroinflammation center

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Item Type:	Article
Title:	Barriers to care for people with unclear visual loss - data from a tertiary-level-of-care neuroinflammation center
Creators Name:	Delikaya, Murat, Bereuter, Charlotte, Schroeter, Jan, Nowak, Elisa, Dorsch, Eva-Maria, Kilinska, Lidia, Kuchling, Joseph, Siebert, Nadja, Behrens, Janina, Paul, Friedemann, Bellmann-Strobl, Judith, Schmitz-Hübsch, Tanja and Oertel, Frederike Cosima
Abstract:	BACKGROUND: Visual symptoms are common in people with multiple sclerosis. The revised 2024 McDonald criteria include the optic nerve as a fifth anatomical region, underscoring the need for specific diagnostics. Although optical coherence tomography (OCT) and visual evoked potentials (VEP) are available, the extent of their routine pre-referral use is insufficiently documented. We evaluated pre-referral utilization and hypothesized that specific diagnostics are used less often than non-specific diagnostics and that differences are not explained by demographics alone. METHODS: Retrospective cross-sectional study of 305 patients referred for visual symptoms to a tertiary neuroimmunology clinic in Germany. Analyses focused on people with multiple sclerosis (n = 112) and disease controls with neuromyelitis optica spectrum disorders or myelin oligodendrocyte glycoprotein-associated disease (pwNM; n = 36). RESULTS: In people with multiple sclerosis, only 6.2% received OCT and 33% VEP for their visual complaints, compared to unspecific diagnostics such as cranial magnetic resonance imaging (58%) and lumbar puncture (42%) – independent of demographic factors. CONCLUSION: The pre-referral use of specific neurovisual tests in people with multiple sclerosis with visual symptoms was low relative to non-specific procedures. This suggests heterogeneous integration of neurovisual testing across care levels. In light of the revised McDonald Criteria 2024, prospective multicenter studies should examine implementation and clinical impact.
Keywords:	Barriers in Healthcare, Vision Loss, Neurovisual Impairment, Multiple Sclerosis, NMOSD
Source:	Multiple Sclerosis Journal Experimental Translational and Clinical
ISSN:	2055-2173
Publisher:	Sage Publications
Volume:	11
Number:	4
Page Range:	1-11
Date:	December 2025
Official Publication:	https://doi.org/10.1177/20552173251397772
PubMed:	View item in PubMed

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