Skip to main content

Advertisement

SpringerLink
Log in

Color perception impairment following optic neuritis and its association with retinal atrophy

  • Original Communication
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

Background

Emphasis is often placed on the good recovery of vision following optic neuritis (ON). However, patients continue to perceive difficulties in performing everyday visual tasks and have reduced visual quality of life. This is in addition to documented permanent loss of retinal volume.

Methods

Seventy-five subjects following monocular ON (> 3 months prior to assessment), were evaluated by the Rabin cone contrast test (CCT). Red, green and blue cone contrast scores were extracted for the affected and fellow eyes. Retinal nerve fiber layer (RNFL) and macular volume (MV) were assessed using optical coherence tomography.

Results

Fifty-seven patients had multiple sclerosis and 17 had clinically isolated syndrome. Median time from ON to evaluation was 47 months. Expanded Disability Status Scale (EDSS) ranged between 0 and 6.5 with average of 2 ± 1.3. Cone contrast scores for red, green and blue in the affected eyes were significantly lower than in the fellow eyes. RNFL thickness and MV were reduced in the affected compared to the fellow eyes. Positive correlations between CCT and RNFL were found in both eyes, but much stronger in the affected eyes (r = 0.72, 0.74, 0.5 and 0.53, 0.58, 0.46 for red green and blue in each eye, respectively). Positive correlations between CCT and MV were found in both eyes, but only modestly stronger in the affected eyes.

Conclusions

Impaired chromatic discrimination thresholds quantitatively document persistent functional complaints after ON. There is evidence of dysfunction in both the affected eye and the fellow eye.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Galetta SL et al (2015) Acute optic neuritis: unmet clinical needs and model for new therapies. Neurol Neuroimmunol Neuroinflamm 2(4):e135

    Article  PubMed  PubMed Central  Google Scholar 

  2. Hanson JV et al (2016) Optical coherence tomography in multiple sclerosis. Semin Neurol 36(2):177–184

    Article  PubMed  Google Scholar 

  3. Beck RW et al (1992) A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis. The Optic Neuritis Study Group. N Engl J Med 326(9):581–588

    Article  CAS  PubMed  Google Scholar 

  4. No authors listed (1997) Visual function 5 years after optic neuritis: experience of the optic neuritis treatment trial. The Optic Neuritis Study Group. Arch Ophthalmol 115(12):1545–1552. https://jamanetwork.com/journals/jamaophthalmology/fullarticle/642401

  5. Katz B (1995) The dyschromatopsia of optic neuritis: a descriptive analysis of data from the optic neuritis treatment trial. Trans Am Ophthalmol Soc 93:685–708

    CAS  PubMed  PubMed Central  Google Scholar 

  6. Schneck ME, Haegerstrom-Portnoy G (1997) Color vision defect type and spatial vision in the optic neuritis treatment trial. Invest Ophthalmol Vis Sci 38(11):2278–2289

    CAS  PubMed  Google Scholar 

  7. Cranwell MB et al (2015) Performance on the Farnsworth-Munsell 100-Hue test is significantly related to nonverbal IQ. Invest Ophthalmol Vis Sci 56(5):3171–3178

    Article  PubMed  Google Scholar 

  8. Lampert EJ et al (2015) Color vision impairment in multiple sclerosis points to retinal ganglion cell damage. J Neurol 262(11):2491–2497

    Article  CAS  PubMed  Google Scholar 

  9. Martinez-Lapiscina EH et al (2014) Colour vision impairment is associated with disease severity in multiple sclerosis. Mult Scler 20(9):1207–1216

    Article  PubMed  Google Scholar 

  10. Villoslada P et al (2012) Color vision is strongly associated with retinal thinning in multiple sclerosis. Mult Scler 18(7):991–999

    Article  PubMed  Google Scholar 

  11. Rabin J, Gooch J, Ivan D (2011) Rapid quantification of color vision: the cone contrast test. Invest Ophthalmol Vis Sci 52(2):816–820

    Article  PubMed  Google Scholar 

  12. Fujikawa M et al (2018) Evaluation of clinical validity of the Rabin cone contrast test in normal phakic or pseudophakic eyes and severely dichromatic eyes. Acta Ophthalmol 96(2):e164–e167

    Article  PubMed  Google Scholar 

  13. Balcer LJ et al (2007) Natalizumab reduces visual loss in patients with relapsing multiple sclerosis. Neurology 68(16):1299–1304

    Article  CAS  PubMed  Google Scholar 

  14. Raftopoulos R et al (2016) Phenytoin for neuroprotection in patients with acute optic neuritis: a randomised, placebo-controlled, phase 2 trial. Lancet Neurol 15(3):259–269

    Article  CAS  PubMed  Google Scholar 

  15. Green AJ et al (2017) Clemastine fumarate as a remyelinating therapy for multiple sclerosis (ReBUILD): a randomised, controlled, double-blind, crossover trial. Lancet 390(10111):2481–2489

    Article  CAS  PubMed  Google Scholar 

  16. Lublin FD, Reingold SC (1996) Defining the clinical course of multiple sclerosis: results of an international survey. National Multiple Sclerosis Society (USA) Advisory Committee on Clinical trials of new agents in multiple sclerosis. Neurology 46(4):907–911

    Article  CAS  PubMed  Google Scholar 

  17. Kurtzke JF (1983) Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 33(11):1444–1452

    Article  CAS  PubMed  Google Scholar 

  18. Schippling S et al (2015) Quality control for retinal OCT in multiple sclerosis: validation of the OSCAR-IB criteria. Mult Scler 21(2):163–170

    Article  CAS  PubMed  Google Scholar 

  19. Cruz-Herranz A et al (2016) The APOSTEL recommendations for reporting quantitative optical coherence tomography studies. Neurology 86(24):2303–2309

    Article  PubMed  PubMed Central  Google Scholar 

  20. Mowry EM et al (2009) Vision related quality of life in multiple sclerosis: correlation with new measures of low and high contrast letter acuity. J Neurol Neurosurg Psychiatry 80(7):767–772

    Article  CAS  PubMed  Google Scholar 

  21. Raz N et al (2011) Sustained motion perception deficit following optic neuritis: behavioral and cortical evidence. Neurology 76(24):2103–2111

    Article  CAS  PubMed  Google Scholar 

  22. Almog Y, Nemet A (2010) The correlation between visual acuity and color vision as an indicator of the cause of visual loss. Am J Ophthalmol 149(6):1000–1004

    Article  PubMed  Google Scholar 

  23. Porciatti V, Sartucci F (1996) Retinal and cortical evoked responses to chromatic contrast stimuli. Specific losses in both eyes of patients with multiple sclerosis and unilateral optic neuritis. Brain 119(Pt 3):723–740

    Article  PubMed  Google Scholar 

  24. Evangelou N et al (2001) Size-selective neuronal changes in the anterior optic pathways suggest a differential susceptibility to injury in multiple sclerosis. Brain 124(Pt 9):1813–1820

    Article  CAS  PubMed  Google Scholar 

  25. Toussaint D et al (1983) Clinicopathological study of the visual pathways, eyes, and cerebral hemispheres in 32 cases of disseminated sclerosis. J Clin Neuroophthalmol 3(3):211–220

    CAS  PubMed  Google Scholar 

  26. Green AJ et al (2010) Ocular pathology in multiple sclerosis: retinal atrophy and inflammation irrespective of disease duration. Brain 133(Pt 6):1591–1601

    Article  PubMed  PubMed Central  Google Scholar 

  27. Oberwahrenbrock T et al (2013) Retinal ganglion cell and inner plexiform layer thinning in clinically isolated syndrome. Mult Scler 19(14):1887–1895

    Article  PubMed  Google Scholar 

  28. Brandt AU et al (2011) Primary retinal pathology in multiple sclerosis as detected by optical coherence tomography. Brain 134(Pt 11):e193 (author reply e194)

    Article  CAS  PubMed  Google Scholar 

  29. Balcer LJ et al (2015) Vision and vision-related outcome measures in multiple sclerosis. Brain 138(Pt 1):11–27

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Netta Levin and Ari Green thank the Feldman foundation for their support for Professor Levin’s sabbatical at UCSF.

Author information

Authors and Affiliations

  1. Division of Neuroinflammation and Glial Biology, Department of Neurology, University of California, San Francisco, CA, USA

    Michael Devereux, Nick Baker & Ari Green

  2. Neuro-ophthalmology Division, Department of Ophthalmology, University of California, San Francisco, CA, USA

    Ari Green

  3. fMRI Unit, Department of Neurology, Hadassah Hebrew University Medical Center, POB 12,000, 91120, Jerusalem, Israel

    Netta Levin & Atira Bick

Authors
  1. Netta Levin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael Devereux
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Atira Bick
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nick Baker
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ari Green
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Netta Levin.

Ethics declarations

Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Levin, N., Devereux, M., Bick, A. et al. Color perception impairment following optic neuritis and its association with retinal atrophy. J Neurol 266, 1160–1166 (2019). https://doi.org/10.1007/s00415-019-09246-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00415-019-09246-8

Keywords

Search

Navigation