Department of Ophthalmology (JAK, SCX, RF, FW, JJC), Mayo Clinic Hospital, Rochester, Minnesota; and Department of Neurology (EPF, JJC), Mayo Clinic Hospital, Rochester, Minnesota.
J Neuroophthalmol. 2024 Jun 1;44(2):157-161. doi: 10.1097/WNO.0000000000002116. Epub 2024 Mar 8.
To evaluate the population-based frequency and severity of multiple sclerosis (MS)-related ocular diseases.
Retrospective, population-based study examining patients with MS between January 1, 1998 and December 31, 2011. Patients were identified using the Rochester Epidemiology Project, which is a record-linkage system of medical records for all patient-physician encounters among Olmsted County, Minnesota residents. Diagnosis of MS was confirmed based on neuroimaging, cerebrospinal fluid studies, and serum studies for each patient according to the 2017 McDonald criteria. Patient data were obtained using the medical records and followed through April 1, 2018.
Of the 116 patients with MS, 66% were female and the median age of onset was 36 years (interquartile range 27.5-43.5 years). About half (61/116, 53%) had MS-related neuro-ophthalmic manifestations during their disease course, and about one-fourth (33/116, 28%) had visual symptoms as their presenting symptom of MS, most commonly as optic neuritis (26/116, 22%). Optic neuritis was the leading MS-related ocular condition (37%), followed by internuclear ophthalmoplegia (16%) and nystagmus (13%). Optic neuritis was mostly unilateral (40/43, 93%), with 16% (6/43) having a visual acuity of 20/200 or worse at nadir but ultimately 95% (35/37) improving to a visual acuity of 20/40 or better.
This study provides the population-based frequency of MS-related ocular disease, which demonstrates a high frequency of ocular manifestations in MS both at disease onset and during the disease course, emphasizing the utility of neuro-ophthalmologists, or collaboration between neurologists and ophthalmologists, in the care of patients with MS.
评估多发性硬化症（MS）相关眼病的基于人群的频率和严重程度。
回顾性基于人群的研究，对 1998 年 1 月 1 日至 2011 年 12 月 31 日期间的 MS 患者进行了检查。使用罗切斯特流行病学项目（Rochester Epidemiology Project）识别患者，该项目是明尼苏达州奥姆斯特德县所有患者-医生就诊的病历记录链接系统。根据 2017 年麦当劳标准，对每位患者进行神经影像学、脑脊液研究和血清研究，以确认 MS 的诊断。使用病历获取患者数据，并随访至 2018 年 4 月 1 日。
在 116 名 MS 患者中，66%为女性，发病中位年龄为 36 岁（四分位距 27.5-43.5 岁）。约一半（61/116，53%）在疾病过程中有 MS 相关的神经眼科表现，约四分之一（33/116，28%）有视觉症状作为 MS 的首发症状，最常见的是视神经炎（26/116，22%）。视神经炎是 MS 相关眼病的主要表现（37%），其次是核间性眼肌麻痹（16%）和眼球震颤（13%）。视神经炎大多为单侧（40/43，93%），16%（6/43）在疾病最低点的视力为 20/200 或更差，但最终 95%（35/37）改善到 20/40 或更好的视力。
本研究提供了基于人群的 MS 相关眼病的频率，表明 MS 患者在疾病发作和病程中都有很高的眼部表现发生率，强调了神经眼科医生或神经内科医生与眼科医生之间的合作在 MS 患者的治疗中的重要性。
