Color Discrimination and Visual Perimetry Evaluation in Multiple Sclerosis and Neuromyelitis Optica

Abstract

Purpose: To compare visual performance in color discrimination and visual perimetry of patients with multiple sclerosis (MS) and neuromyelitis optica (NMO) with or without optic neuritis (ON).

Methods: Patients with MS (9 subjects, 17 eyes, 37±9.7 years old) and with NMO (10 subjects, 18 eyes, 36.1±11.8 years old) were studied with biomicroscopy, fundoscopy, and visual acuity measurements. Color vision was evaluated with the full test protocol of Colour Assesment and Diagnosis (CAD) Test. The diameter of the circle with equivalent area of the color discrimination ellipses was measured. Visual perimetry was evaluated by Central 30-2 Threshold Test of the Humphrey Visual Field Analyzer. The two patient groups were compared to each other and to an age- and gender-matched control group. Statistical analyses used: tolerance intervals, binomial test, two-way ANOVA, α=0.05.

Results: After the ophthalmologic evaluation, it was observed that 4 eyes from patients with MS and 6 eyes from patients with NMO had ON. Color discrimination. 2/4 eyes from patients with MS and ON and 4/10 eyes from patients with MS without ON had color discrimination above the upper tolerance limit for controls. 1/6 eyes from patients with NMO and ON and 1/9 eyes from patients with NMO without ON had color discrimination above the upper tolerance limit for controls. Regardless of ON presence, MS had significantly more eyes with altered color discrimination results than NMO (p<0.05). The MS group had statistically lower color discrimination than the control group (p<0.05). Visual perimetry. There were no statistical differences between the number of altered results across the visual field between patients with MS with and without ON. The group with MS and ON had significantly more altered results than NMO with ON and, despite of the disease, there were more altered results in patients with ON than without ON (p<0.05). There were no altered results in the group of NMO without ON across the visual field. The group of NMO with ON had significant lower sensitivity than the control group at all eccentricities and had lower sensitivity than the group of NMO without ON at eccentricity of 20° (p<0.05).

Conclusions: MS was more harmful to color discrimination than NMO, while NMO patients had worse performance in visual perimetry than MS patients. The ON presence impaired the visual function mainly for visual perimetry and NMO patients.

Keywords: 758 visual fields • 759 visual impairment: neuro-ophthalmological disease • 754 visual acuity