The Neuro-ophthalmology of Multiple Sclerosis

Ryan D Walsh; Collin M McClelland; Steven L Galetta

Disclosures

Future Neurology. 2012;7(6):679-700. 

In This Article

Abstract and Introduction

Abstract

Multiple sclerosis (MS) is a disease marked by focal demyelinating inflammatory plaques throughout the CNS. Neuro-ophthalmologic sequelae are common in MS and may arise from the disease itself or from treatment of the disease. Both afferent and efferent functions may be affected. Despite much progress, our understanding of the pathophysiology of MS, and the efficacy of our available treatments, remain inadequate. Here, we review the chief neuro-ophthalmologic abnormalities associated with MS and discuss the emerging diagnostic and therapeutic advances that are likely to further our understanding of MS and its treatment.

Introduction

Multiple sclerosis (MS) is a disease marked by focal demyelinating inflammatory plaques throughout the CNS with axonal damage and gray matter neuronal injury contributing to disease progression and disability.[1–3] With an estimated prevalence of 47.2–109.5 per 100,000 across various latitudes of the USA, the disease afflicts up to 350,000 individuals in this country and results in a serious economic and functional burden.[4] Neuro-ophthalmic sequelae are common in MS and may arise from the disease or treatment of the disease. Demyelinating optic neuritis (DON) occurs at some point in approximately 27–37% of patients with MS[5] while eye movement abnormalities have been noted to occur in 40–76% of patients.[6–8] In this review, the characteristic afferent and efferent neuro-ophthalmic manifestations of MS will be described in the context of the evolving understanding of this complex disease.

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