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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: |
Delikaya, Murat  ORCID: https://orcid.org/0009-0009-0438-8771, Bereuter, Charlotte ORCID: https://orcid.org/0009-0004-7172-8864, Schroeter, Jan, Nowak, Elisa, Dorsch, Eva-Maria ORCID: https://orcid.org/0009-0002-5872-1268, Kilinska, Lidia, Kuchling, Joseph ORCID: https://orcid.org/0000-0002-7981-2073, Siebert, Nadja ORCID: https://orcid.org/0000-0001-6576-7761, Behrens, Janina, Paul, Friedemann ORCID: https://orcid.org/0000-0002-6378-0070, Bellmann-Strobl, Judith ORCID: https://orcid.org/0000-0003-2615-1643, Schmitz-Hübsch, Tanja ORCID: https://orcid.org/0000-0003-4833-5937 and Oertel, Frederike Cosima ORCID: https://orcid.org/0000-0003-4906-5983
|
| 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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