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Sarah Chao Ying Xu, Eoin Flanagan, Feng Wang, Jacqueline Leavitt, John J Chen; The population-based epidemiology of ocular diseases in multiple sclerosis. Invest. Ophthalmol. Vis. Sci. 2018;59(9):622.
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While ocular manifestations occur in multiple sclerosis (MS), their relative frequencies in population-based studies are largely unknown. Because MS-associated ocular conditions cause visual impairment and disability, determining their incidence and prevalence is important to help guide screening for and treatment of ocular disorders in MS patients. The goal of this study is to evaluate the frequency of MS-related ocular diseases in a well-defined population (Olmsted County, MN).
Using the medical records linkage system of the Rochester Epidemiology Project, which captures all patient–physician encounters in Olmsted County (MN), we identified all prevalent MS patients within this county on December 31, 2011. Here we analyze those prevalent MS patients whose onset of MS occurred between 2000 and 2011.
One hundred of the prevalent patients with MS (34 male and 66 female) had symptom onset between 2000 and 2011. The mean age was 37.2 years (SD 11.7). Ocular conditions were the presenting MS symptom in 26 of the total 100 patients: 20 with optic neuritis, 5 with internuclear ophthalmoplegia (INO), and 1 with a visual field defect due to a retrochiasmal lesion. Overall, 47 of 100 MS patients had ocular manifestation of MS during their disease course, with optic neuritis being the most common (70%, 33/47). The mean time of onset of optic neuritis was 1.2 years (SD 2.4) after MS diagnosis. Of the patients with optic neuritis, 55% (18/33) were treated with IV methylprednisone and 70% (19/27 with known final visual acuity) had a final visual acuity of 20/25 or better at least 6 month after the onset of optic neuritis. In addition, 15 of 100 MS patients had INO, 15 had some form of nystagmus after MS diagnosis, 3 had saccadic intrusions, 2 had abnormal smooth pursuit, 2 had sixth nerve palsy, and 1 had skew deviation. There were no documented cases of uveitis or pars planitis. Overall, 42/100 of MS patients were evaluated by a neuro-ophthalmologist at or after the MS diagnosis.
There is a high frequency of ocular manifestations in MS at onset and during the disease course, emphasizing the potential utility of neuro-ophthalmologists in the care of MS patients.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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