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Title: Persistent visual impairment in people with multiple sclerosis : prevalence and functional consequences
Author: McKay, Rachel
ISNI:       0000 0004 7655 5547
Awarding Body: Glasgow Caledonian University
Current Institution: Glasgow Caledonian University
Date of Award: 2018
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Impaired visual function is a concern for up to 80% of people who have received a diagnosis of multiple sclerosis (Balcer 2015). Visual symptoms may represent the most prominent symptoms in pwMS. In this project, the prevalence and impact of persistent visual impairment in people with Multiple Sclerosis (pwMS) was assessed in three stages. Stage One gathered information on self-reported general function and visual function from pwMS. Overall, pwMS reported MS to have a significant impact on daily living using the MSIS-29 questionnaire, however the participants felt that vision impacted less overall on quality of life using the VFQ-25+10 questionnaire. This may be due, in part, to deficits we normally associate with vision being intact as the results from Stage Two conclude, i.e. high contrast visual acuity (HCVA), visual fields, ocular motility and colour vision. Stage two provided a comprehensive clinical assessment of visual and general function in pwMS including the measurement of Contrast Sensitivity Function (CSF) using of the quick CSF (qCSF) computerized paradigm. The results concluded that while HCVA was well preserved in the study population (97.3%), pwMS were found to have significantly reduced CSF in both spatial (88.2%) and temporal domains (90.9%). Moreover, further investigation of the visual system including extra-cortical visual processing areas in Stage Three suggested that the more severe the MS, the greater the functional deficit not only in CSF but also in global motion and postural stability assessment. In addition to clinical measures of visual performance, the findings from Stage Three suggest that structural measures using Optical Coherence Tomography (OCT) may provide a biomarker for subclinical disease. The study findings conclude that MS has a global effect on the visual system affecting the afferent visual pathway (AVP), striate and extra-striate cortex.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available