ASSESSMENT OF COLOR VISION FOR DIAGNOSIS AND DYNAMIC MONITORING OF MULTIPLE SCLEROSIS

Background: Multiple sclerosis is regarded as the most frequent cause of neurological disability. Visual disturbances are common and may be due to pathology of retina, optic nerve and cerebral conduction tracts (optic tract). Routine methods of assessment of visual function are insufficient in diagnosing some visual problems including color vision disturbances. Aim: To assess color vision in patients with multiple sclerosis. 

Materials and methods: We examined 110 patients (age > 18 years old) with previously diagnosed multiple sclerosis. Neurological status was assessed using functional scales; results of neuroimaging, medical records and history were taken into account. Color vision was examined using Farnsworth dichotomous test. Control group included 20 healthy volunteers (8 men, 12 women, mean age 29.1 ± 1.4 years old). 

Results: In patients with multiple sclerosis, color vision defects were significantly more prevalent compared to the control group (89.1% vs. 65%, p < 0.05). Deuteranopia was found in 18.6% of patients with multiple sclerosis, protanopia in 17.3%, tritanopia in 7.3% of patients. Significant color vision defects positively correlated with disability level of the Expanded Disability Status Scale (EDSS) and were independent of disease duration and history of retrobulbar neuritis. 

Conclusion: In patients with multiple sclerosis, color vision defects were associated with the activity of pathological process. Severity of neurological disability level estimated by EDSS positively correlated with visual disturbances. Thus, Farnsworth dichotomous test may be recommended for dynamic monitoring of multiple sclerosis.