Moss Heather E, Samelson Monica, Mohan Girish, Jiang Qin Li
Department of Ophthalmology and Visual Sciences, Division of Neuro-ophthalmology, University of Illinois at Chicago, Chicago, Illinois, United States of America.
Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, Illinois, United States of America.
PLoS One. 2016 Dec 29;11(12):e0168714. doi: 10.1371/journal.pone.0168714. eCollection 2016.
The afferent visual system may be affected by neuro-degeneration in amyotrophic lateral sclerosis (ALS) based on observations of visual function impairment and retinal inclusions on histopathology in ALS patients. To test the hypothesis that visual acuity is impaired in ALS, we compared three measures of visual acuity in ALS patients (n = 25) attending a multidisciplinary ALS clinic and age matched control subjects (n = 25). Bilateral monocular and binocular visual acuities were assessed using high contrast (black letters on white background) and low contrast (2.5%, 1.25% grey letters on white background) visual acuity charts under controlled lighting conditions following refraction. Binocular summation was calculated as the difference between binocular and best monocular acuity scores. There were no associations between binocular or monocular high contrast visual acuity or low contrast visual acuity and amyotrophic lateral sclerosis diagnosis (generalized estimating equation models accounting for age). Binocular summation was similar in both amyotrophic lateral sclerosis and control subjects. There was a small magnitude association between increased duration of ALS symptoms and reduced 1.25% low contrast visual acuity. This study does not confirm prior observations of impaired visual acuity in patients with amyotrophic lateral sclerosis and does not support this particular measure of visual function for use in broad scale assessment of visual pathway involvement in ALS patients.
基于对肌萎缩侧索硬化症（ALS）患者视觉功能损害和组织病理学上视网膜包涵体的观察，传入视觉系统可能会受到ALS神经退行性变的影响。为了验证ALS患者视力受损这一假设，我们比较了在多学科ALS诊所就诊的25例ALS患者和年龄匹配的25例对照受试者的三种视力测量指标。在验光后的可控照明条件下，使用高对比度（白色背景上的黑色字母）和低对比度（白色背景上2.5%、1.25%的灰色字母）视力表评估双眼单眼和双眼视力。双眼总和计算为双眼视力与最佳单眼视力得分之间的差值。双眼或单眼高对比度视力或低对比度视力与肌萎缩侧索硬化症诊断之间无关联（考虑年龄的广义估计方程模型）。ALS患者和对照受试者的双眼总和相似。ALS症状持续时间增加与1.25%低对比度视力降低之间存在小幅度关联。本研究未证实先前关于ALS患者视力受损的观察结果，也不支持将这种特定的视觉功能测量方法用于广泛评估ALS患者的视觉通路受累情况。
