Visual field impairment captures disease burden in multiple sclerosis

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• 作者：Santiago Ortiz-Perez ; Magí Andorra ; Bernardo Sanchez-Dalmau…
• 关键词：Multiple sclerosis ; Neurodegeneration ; Brain atrophy ; Disability progression ; Visual fields ; Perimetry
• 刊名：Journal of Neurology
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：263
• 期：4
• 页码：695-702
• 全文大小：376 KB
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• 作者单位：Santiago Ortiz-Perez (2)
  Magí Andorra (1)
  Bernardo Sanchez-Dalmau (2)
  Rubén Torres–Torres (2)
  David Calbet (3)
  Erika J. Lampert (1)
  Salut Alba-Arbalat (1)
  Ana M. Guerrero-Zamora (1)
  Irati Zubizarreta (1)
  Nuria Sola-Valls (1)
  Sara Llufriu (1)
  María Sepúlveda (1)
  Albert Saiz (1)
  Pablo Villoslada (1)
  Elena H. Martinez-Lapiscina (1)
  
  2. Department of Ophthalmology, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic of Barcelona, University of Barcelona, Villarroel 170, Barcelona, ES, 08036, Spain
  1. Department of Neurology, Center of Neuroimmunology, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic of Barcelona, University of Barcelona, Villarroel 170, Barcelona, ES, 08036, Spain
  3. Investigacion Estadistica SL, Barcelona, Spain
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Neurology
  Neurosciences
  Neuroradiology
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-1459

文摘

Monitoring disease burden is an unmeet need in multiple sclerosis (MS). Identifying patients at high risk of disability progression will be useful for improving clinical-therapeutic decisions in clinical routine. To evaluate the role of visual field testing in non-optic neuritis eyes (non-ON eyes) as a biomarker of disability progression in MS. In 109 patients of the MS-VisualPath cohort, we evaluated the association between visual field abnormalities and global and cognitive disability markers and brain and retinal imaging markers of neuroaxonal injury using linear regression models adjusted for sex, age, disease duration and use of disease-modifying therapies. We evaluated the risk of disability progression associated to have baseline impaired visual field after 3 years of follow-up. Sixty-two percent of patients showed visual field defects in non-ON eyes. Visual field mean deviation was statistically associated with global disability; brain (normalized brain parenchymal, gray matter volume and lesion load) and retinal (peripapillary retinal nerve fiber layer thickness and macular ganglion cell complex thickness) markers of neuroaxonal damage. Patients with impaired visual field had statistically significative greater disability, lower normalized brain parenchymal volume and higher lesion volume than patients with normal visual field testing. MS patients with baseline impaired VF tripled the risk of disability progression during follow-up [OR = 3.35; 95 % CI (1.10–10.19); p = 0.033]. The association of visual field impairment with greater disability and neuroaxonal injury and higher risk of disability progression suggest that VF could be used to monitor MS disease burden.