Multiple sclerosis. Part I: neuro-ophthalmic manifestations.

PURPOSE OF REVIEW: This update includes topics relating to multiple sclerosis (MS) for the ophthalmologist.

RECENT FINDINGS: Interest in the ophthalmology of MS is highlighted by the substantial amount of original research presented at recent medical conferences. At the 2008 World Congress on Treatment and Research in Multiple Sclerosis, 33 of 898 abstract presentations related to ophthalmology. The most represented topics were optical coherence tomography (OCT) and radiology of the visual system (19/33 posters). The 2009 North American neuro-ophthalmologic society (NANOS) conference featured MS-related topics in 6 of 24 platform presentations. This article reviews recent advancements in the neuro-ophthalmology of MS.

SUMMARY: Multiple sclerosis results in various ophthalmic abnormalities. Optic neuritis is the most widely studied visual disturbance in MS, but other unusual visual manifestations such as Charles Bonnet syndrome or the Pulfrich phenomenon also occur. OCT is used to measure thickness of the retinal nerve fiber layer. Because thinning of this layer in MS represents axonal loss, OCT is being used to evaluate neuroprotective treatments. The efferent visual system, in particular the medial longitudinal fasciculus pathway, may be a way to measure body temperature-induced changes in MS.