Vighetto A, Grochowicki M, Cousin J
Hôpital Neurologique et Neuro-Chirurgical P. Wertheimer, Lyon.
Rev Neurol (Paris). 1990;146(4):264-70.
Spatial contrast sensitivity was measured in 110 patients with multiple sclerosis (definite = 72, probable = 22, possible = 16) as part of a routine evaluation in a neuro-ophthalmological clinic. Results were compared with those of 37 normal controls matched for age. The test was abnormal in 71 p. 100 of patients. Contrast sensitivity was attenuated for 97 p. 100 of the eyes with optic neuritis and visual acuity drop, for 60 p. 100 of the eyes with recovered optic neuritis and for 36 p. 100 of the non affected eyes in the cases of unilateral optic neuritis. Among the 57 patients with normal visual acuity and no history of optic neuritis, 62 p. 100 had abnormal findings. Globally, contrast sensitivity was reduced on the whole spatial frequency range in cases of current optic neuritis, and mostly on the high or high and medium frequencies in the other cases. Our study confirms that spatial contrast sensitivity is the most sensitive of psychophysical methods to detect subclinical visual impairement in multiple sclerosis. Comparison with VEP's was performed in 66 patients. Both tests were roughly equally sensitive, but findings were concordant in only 63 p. 100 of the cases. The use of both VEP's and spatial contrast sensitivity increases the detection of latent optic neuritis.
在一家神经眼科诊所的常规评估中,对110例多发性硬化症患者(确诊72例、可能22例、疑似16例)进行了空间对比敏感度测量。将结果与37名年龄匹配的正常对照者的结果进行比较。71%的患者测试结果异常。在视神经炎和视力下降的眼中,97%的患者对比敏感度降低;在视神经炎已恢复的眼中,60%的患者对比敏感度降低;在单侧视神经炎病例中,未受影响的眼中36%的患者对比敏感度降低。在57例视力正常且无视神经炎病史的患者中,62%有异常发现。总体而言,在当前视神经炎病例中,整个空间频率范围内的对比敏感度均降低,在其他病例中,大多在高频或高频及中频降低。我们的研究证实,空间对比敏感度是检测多发性硬化症亚临床视力损害的心理物理学方法中最敏感的。对66例患者进行了与视觉诱发电位(VEP)的比较。两种测试的敏感度大致相同,但仅63%的病例结果一致。同时使用VEP和空间对比敏感度可提高对视神经炎潜在病例的检测率。