Optical Coherence Tomography (OCT) Measures Are Associated with Patient Self-Reported Vision Scores in Persons with Multiple Sclerosis (MS)

Background: Patients with MS often experience thinning of the Retinal Nerve Fiber Layer (RNFL) and Peri-Macular Bundle (PMB), and a decrease of Macular Volume (MV). It is unknown whether patient self-reported vision loss correlates with OCT findings.

Objectives: To assess for a relationship between OCT measures and patient-reported vision scores extracted from symptoMScreen, a novel and validated MS symptom severity scale.

Methods: OCT exams and symptoMScreen, which includes a vision domain on a scale between 0 (not affected) and 6 (total limitation), were administered to consecutive MS patients at our center. Exclusion criteria included relapse within the last 3 months, diabetes, amblyopia, glaucoma, ocular hypertension, angle closure, and disc hemorrhage. RNFL, PMB, and MV data was extracted from OCT reports. A multiple linear regression was performed to control for the effects of age, gender, disease duration, and MS sub-type on significant correlations between symptoMScreen vision scores and OCT data.

Results: 139 patients with clinician-confirmed MS (77% female, average age 45.37 +/- 10.92, average disease duration 11.50 +/- 8.50, and 85% RRMS) participated. The average vision score on the symptoMScreen was 0.96. Multiple linear regressions were performed on significant correlations between the vision domain and OCT data.  MV of the right eye (OD) and left eye (OS), and RNFL and PMB of OS were significantly predicted by self-reported vision. The regression on MV of OD yielded the strongest and most significant regression equation F (5, 133) = 2.83, p<.05, R²=.10. Of the variables, only the vision domain (β=-.21) added statistical significance to the prediction, p<.05. The regression equation for MV of OS, RNFL of OS, and PMB of OS were, respectively: F (5, 133) = 4.30, p<.01, R²=.14; F (5, 133) = 3.59, p<.01, R²=.12; and F (5, 133) = 2.72, p<.05, R²=.093. For each, the vision domain (β=-.17, β=-.19, and β=-.18, respectively) added statistical significance to the prediction, p<0.5.

Conclusions: Worse self-reported vision predicted lower values for OCT data, representative of the adverse ophthalmic changes that accompany demyelinating disease.  Findings were most significant for MV of OD. Overall, though statistically significant, the relationship between self-reported vision and OCT measures was modest.