Dyschromatopsia in multiple sclerosis reflects diffuse chronic neurodegeneration beyond anatomical landmarks
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ORIGINAL ARTICLE
Dyschromatopsia in multiple sclerosis reflects diffuse chronic neurodegeneration beyond anatomical landmarks Antonio Barreiro‑González1 · Maria T. Sanz2 · Sara Carratalà‑Boscà3 · Francisco Pérez‑Miralles3 · Carmen Alcalá3 · Enrique España‑Gregori1,4 · Bonaventura Casanova3,5 Received: 16 April 2020 / Accepted: 28 September 2020 © Belgian Neurological Society 2020
Abstract To formulate and validate a dyschromatopsia linear regression model in patients with multiple sclerosis (MS). 64 MS patients (50 to formulate the model and 14 for its validation) underwent neurological (Expanded Disability Status Scale, EDSS), color vision (Farnsworth D15 test), and peripapillary retinal nerve fiber layer (pRNFL) and retinal evaluation with spectral-domain optical coherence tomography (SD-OCT). Neuroradiological examination permitted to obtain brain parenchymal fraction (BPF) and cervical spinal cord volume (SC). Ophthalmic parameters were calculated as the average of both non-optic neuritis (ON) eyes, and in case the patient had previous ON, the value of the fellow non-ON eye was taken. The influence of sex, age, disease duration, and history of disease-modifying treatment (first- or second-line DMT) was tested as covariables that could influence color perception. Color confusion index (log CCI) correlated with pRNFL (r = − 0.322, p = 0.009), ganglion cell layer (GCL, r = − 0.321, p = 0.01), BPF (r = − 0.287, p = 0.021), SC volume (r = − 0.33, p = 0.008), patients’ age (r = 0.417, p = 0.001), disease duration (r = 0.371, p = 0.003), and EDSS (r = 0.44, p = 0.001). The following CCI equation was obtained: log (CCI) = 0.316–0.224 BPF − 0.187 SC volume (mm3) + 0.226 age (years) + 0.012 disease duration (years) − 0.372 GCL (µm). CCI correlates with MS clinical and paraclinical established biomarkers suggesting chronic diffuse neurodegeneration in MS operates at brain, SC, and retina linking all three compartments. Color vision outcome can be calculated through the aforementioned variables for clinical and research purposes. Keywords Color vision defects · Magnetic resonance imaging · Multiple sclerosis · Neurodegeneration · Optical coherence tomography
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s13760-020-01516-x) contains supplementary material, which is available to authorized users. * Antonio Barreiro‑González [email protected] 1
Ophthalmology Department, University and Polytechnic Hospital La Fe, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain
2
Departamento de Didáctica de La Matemática, Universidad de Valencia, Valencia, Spain
3
Neurology Department, University and Polytechnic Hospital La Fe, Valencia, Spain
4
Surgery Department, Faculty of Medicine, University of Valencia, Valencia, Spain
5
Medicine Department, Faculty of Medicine, University of Valencia, Valencia, Spain
Multiple sclerosis (MS) patients usually suffer from vision problems, mainly caused by acute optic neuritis (ON)
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