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العنوان
Prevalence of Ophthalmological Manifestations of Multiple Sclerosis /
المؤلف
EL-Samman, Noha Hamed Aly.
هيئة الاعداد
باحث / Noha Hamed Aly EL-Samman
مشرف / Ayman Abd El-Moneim Gaafar
مشرف / Dina Abd El-Gwad Zamzam
مناقش / Ahmed Mohamed El-Bayomi
تاريخ النشر
2019.
عدد الصفحات
104 P. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
طب العيون
تاريخ الإجازة
1/1/2019
مكان الإجازة
جامعة عين شمس - كلية الطب - قسم طب وجراحة العيون
الفهرس
Only 14 pages are availabe for public view

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Abstract

Multiple sclerosis (MS) is an immune mediated inflammatory disease that affects the myelin of the central nervous system and can cause many neurologic deficits. MS is a disease with a heterogeneous presentation and different disease course. Recent studies indicate increasing prevalence of MS in the Middle East.
One hundred participants followed as out-patients in MS unit, Department of Neurology, Ain Shams University Hospital were included in this study. All patients were subjected to full ophthalmic examination in order to assess the neuro-ophthalmic manifestations and their correlation with visual dysfunction in patients of multiple sclerosis.
This study proved the evidence that optic neuritis is the most common visual manifestation of MS and is often the initial presentation of MS as we reported that in 36 patients (36%) the disease started with acute optic neuritis that was unilateral in 31% and bilateral in 5%.
During the course of the disease 44 patients (44%) had at least one attack of acute optic neuritis. It usually causes acute unilateral visual dysfunction and it has been a very common early manifestation of MS. It is often accompanied by visual field loss, color desaturation and relative afferent pupillary defect. Although most patients’ visual acuity recovers to baseline after an episode of optic neuritis, residual deficits in contrast sensitivity are common.
The disease started with acute ocular motor manifestation in 6 patients (6%). During the course of the disease 31 patients (31%) had at least one attack of acute ocular motor manifestation.
In this study 17% of patients had internuclear ophthalmoplegia and it was bilateral in 1 patient, 1% of patients had 6th cranial nerve palsy and 12% of patients complained of nystagmus after exclusion of patients complaining of internuclear ophthalmoplegia.
An impaired corrected visual acuity was observed in 35% of patients that was bilateral in 21% and unilateral in 14% with a mean value 0.14 ± 0.23.
We found among this cohort 49% of patients to have impaired contrast sensitivity that was bilateral in 21% and unilateral in 28% with a mean value 1.83 ±0.24.
Visual field was impaired in 3% of patients; 1% with central field defect and 2% with bitemporal hemianopia. Color discrimination was impaired in 12% of patients; 10% were unilateral and 2% were bilateral. Disc pallor was observed in 11% of patients.
In this study we found that there is a statistically significant correlation between RAPD in patients with no optic neuritis attacks and patients with at least 1 relapse (P value= 0.032). Also we found a statistically significant correlation between disc pallor in patients with no optic neuritis relapses and patients with at least 1 relapse (P value= 0.007).
Also we found that there is a statistically significant correlation between number of relapses of ocular motor symptoms and visual function impairment (best corrected visual acuity with a P value= 0.025, contrast sensitivity with a P value= 0.027 and color vision with a P value= 0.039).