Subclinical retinal injury occurs in pediatric-onset MS patients without a history of ON. As in adult-onset MS, substantial GCL thinning is present in eyes with prior ON. Finally, greater retinal axonal injury occurs in boys compared to girls.
Several randomized trials have demonstrated potential benefit of cannabis derivatives in the symptomatic treatment of multiple sclerosis (MS) patients. These provide class 1 and 2 evidence for cannabinoid product use for spasticity and pain in these patients. The precise best ratio or doses are not yet clear. The safety and potential long-term effects of these products on cognitive function in people with MS have not been evaluated. Since short-term memory and processing speed can be significantly impaired in many people with MS, the concern of potential cognitive impairment related to cannabis products needs consideration in clinical care and should be addressed in longer, prospective studies.
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