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Brain. 2015 Jan;138(Pt 1):11-27. doi: 10.1093/brain/awu335. Epub 2014 Nov 28.

Vision and vision-related outcome measures in multiple sclerosis.

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1 Departments of Neurology, Ophthalmology and Population Health, New York University School of Medicine, NY 10016, USA.
2 Queen Square MS Centre, UCL Institute of Neurology, London, WC1N 3BG, UK.
3 Scientific and Clinical Review Associates, LLC, CT 06068, USA.
4 Neurological Institute, Cleveland Clinic, OH 44195, USA


Visual impairment is a key manifestation of multiple sclerosis. Acute optic neuritis is a common, often presenting manifestation, but visual deficits and structural loss of retinal axonal and neuronal integrity can occur even without a history of optic neuritis. Interest in vision in multiple sclerosis is growing, partially in response to the development of sensitive visual function tests, structural markers such as optical coherence tomography and magnetic resonance imaging, and quality of life measures that give clinical meaning to the structure-function correlations that are unique to the afferent visual pathway. Abnormal eye movements also are common in multiple sclerosis, but quantitative assessment methods that can be applied in practice and clinical trials are not readily available. We summarize here a comprehensive literature search and the discussion at a recent international meeting of investigators involved in the development and study of visual outcomes in multiple sclerosis, which had, as its overriding goals, to review the state of the field and identify areas for future research. We review data and principles to help us understand the importance of vision as a model for outcomes assessment in clinical practice and therapeutic trials in multiple sclerosis.


clinical trials methodology; multiple sclerosis; neuro-ophthalmology; optic neuritis; vision

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