Visual acuity and contrast sensitivity in multiple sclerosis--hidden visual loss: an auxiliary diagnostic test

Brain : a Journal of Neurology
D ReganT J Murray

Abstract

In 48 patients with multiple sclerosis sine-wave gratings were used to test visual sensitivity for coarse, medium, and fine detail rather than measuring visual acuity for fine detail only, as in conventional clinical tests. In 20/48 patients the test revealed a visual defect of neural origin, qualitatively different from that caused by refractive error. In 11 of these 20 patients, visual sensitivity to detail of medium coarseness was markedly degraded, even though sensitivity to both coarse and fine detail was unimpaired. In 3 of these 20 patients visual sensitivity to coarse detail was selectively degraded. These visual defects could not be detected by the Snellen test, yet the patient might experience visual problems in everyday life and also experience distorted visual perception. Possible neural bases for these visual impairments are discussed. Since 8 of the 14 patients with selective loss showed no clinical evidence of visual involvement, the test can aid the earlier diagnosis of multiple sclerosis.

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Related Concepts

Teens
Differential Diagnosis
Form Perception
Multiple Sclerosis, Acute Fulminating
Neuropapillitis
Refractive Errors
Visual Impairment
Vision Tests
Visual Acuity

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