Anatomic and functional correlation of frequency-doubling technology perimetry (FDTP) in multiple sclerosis

Abstract

To study the correlation between the results of frequency-doubling technology perimetry (FDTP), visual function (visual acuity, contrast vision, standard automated perimetry (SAP)) and the thickness of the retinal nerve fiber layer (RNFL) throughout the course of multiple sclerosis (MS). Sixty-six eyes of thirty-three patients suffering from MS were chosen. Thirty-five eyes had a previous history of optic neuritis (ON group) and thirty-one eyes had no previous history of optic neuritis (non-ON group). The FDTP was performed with the N-30 screening program. Visual acuity was determined with the Snellen scale and the ETDRS (Early Treatment Diabetic Retinopathy Study) scale, the contrast vision with the Pelli-Robson and Sloan tests and the SAP with the Humphrey 750 perimeter. The thickness of the RNFL was measured using the STRATUS OCT™ optical coherence tomography (OCT). The visual field FDTP was divided into three sectors corresponding to the three SAP sectors and to the three RNFL quadrants of the OCT. The FDTP was significantly correlated (P<0.0001) to the contrast vision and to the SAP results (mean deviation (MD) and the different sectors among themselves). In the ON group, the MD FDTP was significantly correlated to the average RNFL thickness (r=0.44, P=0.0091). A decrease of 5 decibels (dB) of the MD FDTP corresponded to a decrease of 11.7 μm of the average RNFL thickness (Y=2.34×X+87.5). The strong correlation with SAP and RNFL confirms the value of FDTP in assessing optic nerve damage throughout the course of MS.

Bruch Membrane Opening Minimum Rim Width in Neuromyelitis Optica

“…To the best of our knowledge, this is the first study evaluating the correlation between BMO and different areas of the visual field during demyelinating diseases. A high correlation was found, as for RNFL and GCL in similar studies of patients with and without a history of ON (37,38). Essentially studied during glaucoma neuropathy, the correlation between BMO and MD is at least close to or sometimes better than the RNFL.…”

Evaluation of contrast sensitivity measurements after retrobulbar optic neuritis in Multiple Sclerosis

“…In addition, an RNFL below 75 μm was significantly correlated with visual field defects. It has been observed that despite the fact that visual acuity returned to normal after optic neuritis, patients still complain of subjective decreased vision, which may result from decreased contrast sensitivity or visual field defects [21, 31, 34]. …”

“…It is estimated that about 15–20 % of patients with multiple sclerosis are diagnosed with optic neuritis in the course of the disease [1, 20]. There are articles suggesting that this proportion is much higher and may be as high as 50 % [1, 21, 22]. The main symptoms include: subacute, unilateral, and decreased visual acuity, which may be accompanied by dyschromatopsy, decreased contrast sensitivity, phosphenes (positive visual phenomena) seen as white or colorful flashes, as well as ocular pain or pain around the eyeball, which increases with eye movement and afferent pupillary defect.…”

Optical Coherence Tomography in Multiple Sclerosis

“…48 Visual field sensitivity (as measured by the mean deviation (MD) from age-matched normal values) is reduced in MS patients relative to normal subjects, with the greatest reduction being observed in those eyes with a history of ON. 49,50 Mean deviation is correlated with TD-OCT-derived RNFL thickness in MS eyes with a history of ON, 51,52 although the quantitative relationship with deeper retinal layers remains unstudied. Given that MS patients are prone to fatigue 53 and the adverse effects of fatigue on both visual sensitivity and reliability when performing perimetry, 48 more objective measures of visual function (such as electrophysiology) are likely to be helpful when assessing MS patients.…”