Gil-Casas Amparo, Piñero David P, Molina-Martin Ainhoa
Clínica Optométrica, Foundation Lluís Alcanyís, University of Valencia, Valencia, Spain.
Optics and Visual Perception Group (GOPV). Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain.
Semin Ophthalmol. 2020 Feb 17;35(2):103-115. doi: 10.1080/08820538.2020.1744671. Epub 2020 Mar 31.
Multiple sclerosis (MS) is an acquired demyelinating and inflammatory neurodegenerative disease affecting the central nervous system (CNS). Clinical and subclinical ocular disturbances occur in almost all patients with MS. The objective of this narrative review was to collect and summarize the available scientific information on oculomotor, accommodative and binocular alterations that have been reported in MS. A systematic search strategy with the following descriptors was carried out: multiple sclerosis, ocular motility disorders, internuclear ophthalmoplegia, nystagmus, vergences, fixation, pupil reflex, accommodation and stereopsis. According to the search, some oculomotor alterations were found to be commonly reported in MS, such as alterations in saccades and nystagmus. In contrast, accommodative, vergence and stereopsis alterations have not been comprehensively studied despite their relevance, with only minimal evidence showing a potential negative impact of the disease on these aspects. In conclusion, oculomotor impairment is a common component of disability in MS patients and should be considered when managing this type of patients. More research is still needed to know the real impact of this disease on binocular vision and accommodation.
多发性硬化症（MS）是一种获得性脱髓鞘和炎症性神经退行性疾病，影响中枢神经系统（CNS）。几乎所有MS患者都会出现临床和亚临床眼部功能障碍。本叙述性综述的目的是收集和总结MS中已报道的关于眼球运动、调节和双眼功能改变的现有科学信息。采用以下描述符进行了系统的检索策略：多发性硬化症、眼球运动障碍、核间性眼肌麻痹、眼球震颤、聚散、注视、瞳孔反射、调节和立体视觉。根据检索结果，发现一些眼球运动改变在MS中较为常见，如扫视和眼球震颤的改变。相比之下，尽管调节、聚散和立体视觉改变具有相关性，但尚未得到全面研究，仅有极少证据表明该疾病对这些方面可能产生负面影响。总之，眼球运动障碍是MS患者残疾的常见组成部分，在管理这类患者时应予以考虑。仍需要更多研究来了解该疾病对双眼视觉和调节的实际影响。
