Value of Pelli-Robson contrast sensitivity chart for evaluation of visual system in multiple sclerosis patients. 2007

Mieczysław Wender
Neuroimmunological Unit, Medical Research Centre, Polish Academy of Sciences, Poznañ, Poland. mwender@am.poznan.pl

OBJECTIVE The Multiple Sclerosis Functional Composite (MSFC) score, in addition to the commonly used EDSS scale, is one of the standard procedures used for a quantitative evaluation of the clinical state of patients with multiple sclerosis (MS). These methods, however, do not include an evaluation of the visual system. Hence, a search for sensitive tests evaluating the state of the visual system is important. Our study aims to answer the question whether the examination of contrast discrimination by means of the Pelli-Robson method is of any objective value for clinical practice. METHODS 100 Patients presenting with MS and 29 healthy subjects with 100% visual acuity (assessed by means of Snellen's scale) were included in the study. The examination of visual acuity was performed by means of a contrast discrimination chart (Pelli-Robson) according to the instructions provided by the manufacturer. RESULTS Contrast discrimination capacity was found to be significantly lower in the group of MS patients than that established in the control group. The same observation holds true for the subgroup of MS patients presenting with normal visual acuity, measured with the Snellen scale. Categorization of results showed that values <1.40 lg of contrast discrimination were not found in healthy subjects. CONCLUSIONS The Pelli-Robson contrast discrimination test is a more sensitive procedure for detecting visual disturbances than the visual acuity test according to Snellen. The Pelli-Robson test thus constitutes a valuable supplement of the examination triad routinely involved in the MSFC for evaluation of the clinical status of patients, especially in the dynamic aspect of the outcome measure.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009103 Multiple Sclerosis An autoimmune disorder mainly affecting young adults and characterized by destruction of myelin in the central nervous system. Pathologic findings include multiple sharply demarcated areas of demyelination throughout the white matter of the central nervous system. Clinical manifestations include visual loss, extra-ocular movement disorders, paresthesias, loss of sensation, weakness, dysarthria, spasticity, ataxia, and bladder dysfunction. The usual pattern is one of recurrent attacks followed by partial recovery (see MULTIPLE SCLEROSIS, RELAPSING-REMITTING), but acute fulminating and chronic progressive forms (see MULTIPLE SCLEROSIS, CHRONIC PROGRESSIVE) also occur. (Adams et al., Principles of Neurology, 6th ed, p903) MS (Multiple Sclerosis),Multiple Sclerosis, Acute Fulminating,Sclerosis, Disseminated,Disseminated Sclerosis,Sclerosis, Multiple
D011237 Predictive Value of Tests In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test. Negative Predictive Value,Positive Predictive Value,Predictive Value Of Test,Predictive Values Of Tests,Negative Predictive Values,Positive Predictive Values,Predictive Value, Negative,Predictive Value, Positive
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012680 Sensitivity and Specificity Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed) Specificity,Sensitivity,Specificity and Sensitivity
D012720 Severity of Illness Index Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder. Illness Index Severities,Illness Index Severity
D014786 Vision Disorders Visual impairments limiting one or more of the basic functions of the eye: visual acuity, dark adaptation, color vision, or peripheral vision. These may result from EYE DISEASES; OPTIC NERVE DISEASES; VISUAL PATHWAY diseases; OCCIPITAL LOBE diseases; OCULAR MOTILITY DISORDERS; and other conditions (From Newell, Ophthalmology: Principles and Concepts, 7th ed, p132). Hemeralopia,Macropsia,Micropsia,Day Blindness,Metamorphopsia,Vision Disability,Visual Disorders,Visual Impairment,Blindness, Day,Disabilities, Vision,Disability, Vision,Disorder, Visual,Disorders, Visual,Hemeralopias,Impairment, Visual,Impairments, Visual,Macropsias,Metamorphopsias,Micropsias,Vision Disabilities,Vision Disorder,Visual Disorder,Visual Impairments

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