Correlations Between Disability Score, Optical Coherence Tomography and Microperimetry in Patients with Multiple Sclerosis

Abstract

Carla D Guantay,1,2 Laura Mena-García,1 Miguel Ángel Tola-Arribas,3,4 María José Garea García-Malvar,3 María Isabel Yugueros Fernández,3 Agustín Mayo-Iscar,1,5 José Carlos Pastor1,2 1Instituto Universitario de Oftalmobiología Aplicada (IOBA Eye Institute), Universidad de Valladolid, Valladolid, Spain; 2Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Enfermedades Inflamatorias (REI), Instituto de Salud Carlos III, Madrid, Spain; 3Department of Neurology, Hospital Universitario Río Hortega, Valladolid, Spain; 4Centro de Investigación en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain; 5Department of Statistics and Operational Research and IMUVa, Universidad de Valladolid, Valladolid, SpainCorrespondence: Carla D Guantay, Instituto Universitario de Oftalmobiología Aplicada (IOBA Eye Institute), Universidad de Valladolid, Paseo de Belén 17, Valladolid, 47011, Spain, Tel [phone], Email [email protected]: To characterize ocular motility disturbances through Microperimetry (MP) in patients with Multiple Sclerosis (MS) trying to detect those capable of influencing the disability to improve the accuracy of assessing visual impact in EDSS scale. MP results were compare with some structural parameters obtained by OCT.Patients and Methods: Cross-sectional analytical and correlational case-control study approved by Ethical Committee. A total of 82 eyes (41 patients) and 30 healthy eyes (15 subjects) were enrolled after informed consent. All participants underwent ophthalmological evaluation with MP and OCT. Variables included MS disease duration, Expanded Disability Status Scale (EDSS) score; in OCT: central macular thickness (CMT), ganglion cell-inner plexiform layer thickness (GCIPL), and peripapillary retinal nerve fiber layer thickness (pRNFL); and in MP: test duration, reaction time, average macular threshold (AT), and 4 fixation stability indexes (P1, P2, BCEA63, BCEA95).Results: MS group showed a significant decrease in GCIPL (p < 0.001) and pRNFL thickness (p < 0.001) compared to the control group. Furthermore, patients demonstrated a longer examination (p < 0.001) and reaction (p < 0.001) times, reduced AT (p < 0.001), more unstable fixation indexes (P1 p < 0.004, P2 p = 0.018, BCEA63 p = 0.005 and BCEA95 p = 0.007), measured by MP. In addition, patients with a history of ON (n=16) demonstrated longer examination times in MP (p = 0.049) compared to MS patients without ON, but they were not correlations with OCT measurements, EDSS score correlated with the CMT (p = 0.023, r = − 0.25), MP duration (p = 0.043, r = 0.22), and fixation indexes (P1 p = 0.049, r = − 0.22, BCEA63 p = 0.041, r = 0.23, BCEA95 p = 0.049, r = 0.22).Conclusion: Our study emphasizes the complementary utility of MP and OCT in assessing MS patients. Additionally, it highlights that using MP for objective measurements of oculomotor dysfunction could improves accuracy in disability assessment on the EDSS scale.Keywords: ocular movement anomalies, expanded disability status scale, neurodegenerative diseases, fixation instability, retinal sensitivity

Keywords

• ocular movement anomalies
• expanded disability status scale
• neurodegenerative diseases
• fixation instability
• retinal sensitivity