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Color vision impairment in multiple sclerosis points to retinal ganglion cell damage

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Abstract

Multiple Sclerosis (MS) results in color vision impairment regardless of optic neuritis (ON). The exact location of injury remains undefined. The objective of this study is to identify the region leading to dyschromatopsia in MS patients’ NON-eyes. We evaluated Spearman correlations between color vision and measures of different regions in the afferent visual pathway in 106 MS patients. Regions with significant correlations were included in logistic regression models to assess their independent role in dyschromatopsia. We evaluated color vision with Hardy–Rand–Rittler plates and retinal damage using Optical Coherence Tomography. We ran SIENAX to measure Normalized Brain Parenchymal Volume (NBPV), FIRST for thalamus volume and Freesurfer for visual cortex areas. We found moderate, significant correlations between color vision and macular retinal nerve fiber layer  (rho = 0.289, p = 0.003), ganglion cell complex (GCC = GCIP) (rho = 0.353, p < 0.001), thalamus (rho = 0.361, p < 0.001), and lesion volume within the optic radiations (rho = –0.230, p = 0.030). Only GCC thickness remained significant (p = 0.023) in the logistic regression model. In the final model including lesion load and NBPV as markers of diffuse neuroaxonal damage, GCC remained associated with dyschromatopsia [OR = 0.88 95 % CI (0.80–0.97) p = 0.016]. This association remained significant when we also added sex, age, and disease duration as covariates in the regression model. Dyschromatopsia in NON-eyes is due to damage of retinal ganglion cells (RGC) in MS. Color vision can serve as a marker of RGC damage in MS.

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Acknowledgments

We are extremely grateful to the MS-VisualPath participants and fieldworkers without whose contribution this study would not be possible.

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Authors and Affiliations

  1. Center of Neuroimmunology and Department of Neurology, August Pi Sunyer Institute of Biomedical Research, Hospital Clinic of Barcelona, University of Barcelona, Villaroel 170, Barcelona, ES 08036, Spain

    E. J. Lampert, M. Andorra, S. Llufriu, M. Sepúlveda, N. Sola, A. Saiz, P. Villoslada & Elena H. Martínez-Lapiscina

  2. Center of Neuroimmunology and Department of Ophthalmology, August Pi Sunyer Institute of Biomedical Research, Hospital Clinic of Barcelona, University of Barcelona, Villarroel 170, Barcelona, ES 08036, Spain

    R. Torres-Torres, S. Ortiz-Pérez & B. Sánchez-Dalmau

Authors
  1. E. J. Lampert
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  2. M. Andorra
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  3. R. Torres-Torres
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  4. S. Ortiz-Pérez
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  5. S. Llufriu
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  6. M. Sepúlveda
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  7. N. Sola
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  8. A. Saiz
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  9. B. Sánchez-Dalmau
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  10. P. Villoslada
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  11. Elena H. Martínez-Lapiscina
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Corresponding author

Correspondence to Elena H. Martínez-Lapiscina.

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Conflicts of interest

PV has received consultancy fees from Heidelberg Engineering regarding the clinical applications of OCT. On behalf of all authors, the corresponding author states that there is no conflict of interest for all other authors.

Funding

This study was supported by Instituto de Salud Carlos III, Spain: PS09/00259 and RD07/0060/01 to PV and RD12/0032/0002 to AS. EHML was supported by a fellowship from the Instituto de Salud Carlos III, Spain (Rio Hortega program: CM13/00150). The funding agencies had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript.

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Lampert, E.J., Andorra, M., Torres-Torres, R. et al. Color vision impairment in multiple sclerosis points to retinal ganglion cell damage. J Neurol 262, 2491–2497 (2015). https://doi.org/10.1007/s00415-015-7876-3

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  • DOI: https://doi.org/10.1007/s00415-015-7876-3

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