Routine clinical measurements effective for the evaluation of the impact of multiple sclerosis on vision-related quality of life early in the disease course?

PURPOSE To determine how vision-related quality of life (QoL) correlates to mean and quadrant retinal nerve fiber layer thickness (RNFL) and mean standard deviation in visual field in mildly impaired patients with multiple sclerosis with (MSON) or without (MSNON) previous monocular optic neuritis. METHODS 25 MSNON patients, 14 MSON patients and 22 matched healthy controls were included in this study. Vision-related QoL was assessed with the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ). All patients underwent spectral domain optical coherence tomography (SD OCT) and Humphrey 30 − 2 visual field measurements. OCT images were segmented for the peripapillary retinal nerve fiber layer (pRNFL). RESULTS Vision-realted QoL was better for MSNON patients in comparison to MSON patients (p = 0,037) but worse in comparison to healthy controls (p < 0.001). Peripapillary and quadrant RNFL was not different for MSNON and MSON patients. MD was lower for MSNON patients in comparison to MSON patients (p = 0,047). Finally, vision-related QoL was not in any way associated with all measurements. CONCLUSION This study demonstrates that mildly impaired MS patients still experience a significant decrease of their vision-related QoL, independent of previous acute demyelinating events affecting their visual pathway. This result suggests a review and possible readjustment of the proposed time-frame of intervention. More sensitive than routine clinical measures are warranted in order to predict the impact of early clinical stages of MS on vision.