Ocular fixation and macular integrity by microperimetry in multiple sclerosis
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NEUROPHTHALMOLOGY
Ocular fixation and macular integrity by microperimetry in multiple sclerosis Amparo Gil-Casas 1,2
&
David P. Piñero Llorens 2
&
Ainhoa Molina-Martin 2
Received: 1 April 2020 / Revised: 8 September 2020 / Accepted: 18 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To characterize the fixation and macular integrity of subjects with multiple sclerosis (MS) with and without previous optic neuritis (ON) using microperimetry (MP). Methods Fifty-five eyes of MS patients, subdivided into three groups (28 eyes without ON, 16 with previous ON, and 11 eyes with previous ON in the contralateral eye), and 43 healthy eyes were enrolled (January–November 2018). All cases were evaluated using the MAIA microperimeter (Centervue), analyzing the following parameters: average macular threshold (AT), fixation indexes (P1 and P2), bivariate contour ellipse area (BCEA) for 95% and 63% of points, and horizontal (H) and vertical (V) axes of the ellipse of fixation. Results All MS groups showed a significant reduced AT compared with the control group (p < 0.001). This reduction was more representative (p < 0.001) in eyes with previous ON. No statistically significant differences were found between MS patients with and without previous ON (p > 0.05). Mean AT was correlated with the examination time in all three groups (between ρ = − 0.798 p < 0.001 and ρ = − 0.49 p < 0.001). Significant differences in fixation parameters were only found between control and MS with ON groups (p < 0.02). The ratio of the disease showed a significant correlation with fixation parameters in MS groups (p < 0.02), but not with AT. Conclusions In MS patients, macular sensitivity is altered, especially in eyes with previous ON. Likewise, a fixational instability is present in MS patients with ON, with more increase of the V axis of the fixation area than of the H. The ratio of the disease also affects the patient fixation pattern. Keywords Multiple sclerosis . Microperimetry . Ocular fixation . Macular threshold . Perimetry
Introduction
* David P. Piñero Llorens [email protected] Amparo Gil-Casas [email protected] Ainhoa Molina-Martin [email protected] 1
Clínica Optométrica – Foundation Lluís Alcanyís, University of Valencia, Valencia, Spain
2
Optics and Visual Perception Group (GOPV). Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig s/n 03016. San Vicente del Raspeig, Alicante, Spain
Multiple sclerosis (MS) is an acquired progressive demyelinating and inflammatory disease of the central nervous system (CNS). It is characterized by wide variations between patients, as damage accumulates by chronic relapsing and remitting, and symptoms become more permanent [1]. MS can be diagnosed at any age, although its onset is commonly reported between 25 and 35 years old. It is the leading cause of nontraumatic disability in young adults [2], and is twice as common in women as in men [3]. Visual system is severely affected by MS, being
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