Gil-Casas Amparo, Piñero-Llorens David P, Molina-Martin Ainhoa
Clínica Optométrica, Fundació Lluís Alcanyís, University of Valencia, Valencia, Spain.
Optics and Visual Perception Group (GOPV), Department of Optics, Pharmacology, and Anatomy, University of Alicante, Alicante, Spain.
Clin Optom (Auckl). 2021 Feb 12;13:39-49. doi: 10.2147/OPTO.S286862. eCollection 2021.
Oculomotor disorders have been reported in multiple sclerosis (MS) in up to 80% of cases. There have been studies evaluating binocular vision in several neurological diseases, but not in MS. Considering that a high percentage of eye-movement anomalies have been reported, the aim of this study was to analyze binocular vision in these subjects.
A total of 59 participants with MS - 21 with monocular optic neuritis, eleven with binocular optic neuritis, and 27 without optic neuritis - and 26 age-matched controls were enrolled. Binocular vision was analyzed using near point of convergence (NPC), positive and negative fusional vergence for far and near distance, measurement of heterophoria at both distances with cover and modified Thorington tests, and random-dot stereoscopy.
The percentage of subjects with abnormal NPC values was highest in the MS group, followed by the MSONm (MS with optic neuritis in one eye), MSONb (MS with optic neuritis in both eyes), and control groups. MS patients showed an esophoric trend at near distance. Positive fusional vergence showed no significant differences between control and MS groups, but higher variability in recovery was found in MS groups. Negative fusional vergence at near distance showed significant differences between the control group and the two MS groups, with optic neuritis for both break-point and recovery values. A high percentage of patients with MS had alterations on stereopsis.
Alterations in binocular vision were present in MS, with divergence at near distance and stereopsis the most affected parameters. Likewise, MS patients with optic neuritis showed worse binocular vision.
据报道,高达80%的多发性硬化症(MS)患者存在动眼神经障碍。已有多项研究评估了几种神经系统疾病中的双眼视觉,但未涉及MS。鉴于已报道有高比例的眼球运动异常,本研究旨在分析这些患者的双眼视觉。
共纳入59例MS患者,其中21例患有单眼视神经炎,11例患有双眼视神经炎,27例无视神经炎,以及26例年龄匹配的对照组。使用集合近点(NPC)、远近距离的正负融合性聚散、遮盖法和改良Thorington试验测量两个距离的隐斜视以及随机点立体视觉来分析双眼视觉。
NPC值异常的受试者百分比在MS组中最高,其次是单眼视神经炎的MS患者(MSONm)、双眼视神经炎的MS患者(MSONb)和对照组。MS患者在近距离时表现出内隐斜趋势。正融合性聚散在对照组和MS组之间无显著差异,但MS组在恢复过程中的变异性更高。近距离的负融合性聚散在对照组与两个MS组之间存在显著差异,在断点和恢复值方面,视神经炎患者均有差异。高比例的MS患者存在立体视觉异常。
MS患者存在双眼视觉改变,近距离散开和立体视觉是受影响最严重的参数。同样,患有视神经炎的MS患者双眼视觉更差。