PMID- 28206829
OWN - NLM
STAT- MEDLINE
DCOM- 20180301
LR  - 20220330
IS  - 1477-0970 (Electronic)
IS  - 1352-4585 (Print)
IS  - 1352-4585 (Linking)
VI  - 23
IP  - 5
DP  - 2017 Apr
TI  - Validity of low-contrast letter acuity as a visual performance outcome measure 
      for multiple sclerosis.
PG  - 734-747
LID - 10.1177/1352458517690822 [doi]
AB  - Low-contrast letter acuity (LCLA) has emerged as the leading outcome measure to 
      assess visual disability in multiple sclerosis (MS) research. As visual 
      dysfunction is one of the most common manifestations of MS, sensitive visual 
      outcome measures are important in examining the effect of treatment. Low-contrast 
      acuity captures visual loss not seen in high-contrast visual acuity (HCVA) 
      measurements. These issues are addressed by the MS Outcome Assessments Consortium 
      (MSOAC), including representatives from advocacy organizations, Food and Drug 
      Administration (FDA), European Medicines Agency (EMA), National Institute of 
      Neurological Disorders and Stroke (NINDS), academic institutions, and industry 
      partners along with persons living with MS. MSOAC goals are acceptance and 
      qualification by regulators of performance outcomes that are highly reliable and 
      valid, practical, cost-effective, and meaningful to persons with MS. A critical 
      step is elucidation of clinically relevant benchmarks, well-defined degrees of 
      disability, and gradients of change that are clinically meaningful. This review 
      shows that MS and disease-free controls have similar median HCVA, while MS 
      patients have significantly lower LCLA. Deficits in LCLA and vision-specific 
      quality of life are found many years after an episode of acute optic neuritis, 
      even when HCVA has recovered. Studies reveal correlations between LCLA and the 
      Expanded Disability Status Score (EDSS), Multiple Sclerosis Functional Composite 
      (MSFC), retinal nerve fiber layer (RNFL) and ganglion cell layer plus inner 
      plexiform layer (GCL + IPL) thickness on optical coherence tomography (OCT), 
      brain magnetic resonance imaging (MRI), visual evoked potential (VEP), 
      electroretinogram (ERG), pupillary function, and King-Devick testing. This review 
      also concludes that a 7-point change in LCLA is clinically meaningful. The 
      overall goal of this review is to describe and characterize the LCLA metric for 
      research and clinical use among persons with MS.
FAU - Balcer, Laura J
AU  - Balcer LJ
AD  - Department of Neurology, New York University School of Medicine, New York, NY, 
      USA.
FAU - Raynowska, Jenelle
AU  - Raynowska J
AD  - Department of Neurology, New York University School of Medicine, New York, NY, 
      USA.
FAU - Nolan, Rachel
AU  - Nolan R
AD  - Department of Neurology, New York University School of Medicine, New York, NY, 
      USA.
FAU - Galetta, Steven L
AU  - Galetta SL
AD  - Department of Neurology, New York University School of Medicine, New York, NY, 
      USA.
FAU - Kapoor, Raju
AU  - Kapoor R
AD  - National Hospital for Neurology and Neurosurgery, London, UK.
FAU - Benedict, Ralph
AU  - Benedict R
AD  - Department of Neurology, University at Buffalo, Buffalo, NY, USA.
FAU - Phillips, Glenn
AU  - Phillips G
AD  - Biogen, Cambridge, MA, USA.
FAU - LaRocca, Nicholas
AU  - LaRocca N
AD  - National Multiple Sclerosis Society, New York, NY, USA.
FAU - Hudson, Lynn
AU  - Hudson L
AD  - Critical Path Institute, Tucson, AZ, USA.
FAU - Rudick, Richard
AU  - Rudick R
AD  - Biogen, Cambridge, MA, USA.
CN  - Multiple Sclerosis Outcome Assessments Consortium
AD  - Multiple Sclerosis Outcome Assessments Consortium (MSOAC), Critical Path 
      Institute, Tucson, AZ, USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20170216
PL  - England
TA  - Mult Scler
JT  - Multiple sclerosis (Houndmills, Basingstoke, England)
JID - 9509185
SB  - IM
CIN - Mult Scler. 2017 Apr;23(5):626-627. PMID: 28206813
MH  - Evoked Potentials, Visual/*physiology
MH  - Humans
MH  - Multiple Sclerosis/*diagnosis/pathology
MH  - *Neurologic Examination/methods
MH  - *Outcome Assessment, Health Care/methods
MH  - Quality of Life
MH  - Visual Acuity/*physiology
PMC - PMC5407511
OTO - NOTNLM
OT  - Multiple sclerosis
OT  - function
OT  - low-contrast letter acuity
OT  - optical coherence tomography
OT  - quality of life
OT  - vision
COIS- Declaration of Conflicting Interests: The author(s) declared no potential 
      conflicts of interest with respect to the research, authorship, and/or 
      publication of this article.
EDAT- 2017/02/17 06:00
MHDA- 2018/03/02 06:00
PMCR- 2017/04/27
CRDT- 2017/02/17 06:00
PHST- 2017/02/17 06:00 [pubmed]
PHST- 2018/03/02 06:00 [medline]
PHST- 2017/02/17 06:00 [entrez]
PHST- 2017/04/27 00:00 [pmc-release]
AID - 10.1177_1352458517690822 [pii]
AID - 10.1177/1352458517690822 [doi]
PST - ppublish
SO  - Mult Scler. 2017 Apr;23(5):734-747. doi: 10.1177/1352458517690822. Epub 2017 Feb 
      16.