Using Acute Optic Neuritis Trials to Assess Neuroprotective and Remyelinating Therapies in Multiple Sclerosis.

Importance: Neuroprotective and remyelinating therapies are required for multiple sclerosis (MS), and acute optic neuritis (AON) is a potential condition to evaluate such treatments.

Objective: To comprehensively assess key biological and methodological aspects of AON trials for testing neuroprotection and remyelination in MS.

Design, Setting, And Participants: The AON-VisualPath prospective cohort study was conducted from February 2011 to November 2018 at the Hospital Clinic of University of Barcelona, Barcelona, Spain.

Early retinal atrophy predicts long-term visual impairment after acute optic neuritis.

Background: Visual recovery after optic neuritis (ON) used to be defined as good, although patients frequently complain of poor vision.

Methods: We carried out a prospective study on 38 consecutive patients with acute ON followed monthly for 6 months and evaluated high- and low-contrast visual acuity (HCVA and LCVA, respectively), quality of vision (National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25)), visual fields, and retinal thickness by spectral domain optical coherence tomography (OCT).

Results: We found significant impaired LCVA and color vision in ON eyes 6 months after acute ON, which impact on quality of life.

Visual field impairment captures disease burden in multiple sclerosis.

Monitoring disease burden is an unmeet need in multiple sclerosis (MS). Identifying patients at high risk of disability progression will be useful for improving clinical-therapeutic decisions in clinical routine. To evaluate the role of visual field testing in non-optic neuritis eyes (non-ON eyes) as a biomarker of disability progression in MS.

Dynamics of retinal injury after acute optic neuritis.

Objective: We set out to assess the dynamics of retinal injury after acute optic neuritis (ON) and their association with clinical visual outcomes.

Methods: Thirty-one consecutive patients with acute ON were prospectively analyzed over a 6-month follow-up period. Each month, we used optical coherence tomography (OCT) to assess the thickness of peripapillary retinal nerve fiber layer (pRNFL) and segmented macular layers, as well as high-contrast visual acuity, low-contrast visual acuity (LCVA), color visual acuity (CVA), and visual fields (VF).

The multiple sclerosis visual pathway cohort: understanding neurodegeneration in MS.

Background: Multiple Sclerosis (MS) is an immune-mediated disease of the Central Nervous System with two major underlying etiopathogenic processes: inflammation and neurodegeneration. The latter determines the prognosis of this disease. MS is the main cause of non-traumatic disability in middle-aged populations.

Treatment of acute optic neuritis and vision complaints in multiple sclerosis.

Multiple sclerosis is an autoimmune demyelinating disorder of the nervous system, in which almost all patients develop some degree of visual impairment during the disease. Optic neuritis is the most common and known visual affection and may be the initial clinical disease manifestation, but visual complaints can have a wide variety of presentations and some of them can lead to clinical confusion. Most symptoms are the result of acute injury and subsequent axonal loss in the afferent and efferent visual pathway, but others may be consequences of treatments.