Dissociation Between Progressive Retinal Nerve Fibre Layer Thinning and Perimetric Change in Multiple Sclerosis-Associated Uveitis
4 affiliations
- 1Department of Ophthalmology, School of Medicine, University of Zagreb, Clinical Hospital Center Zagreb, 10000 Zagreb, Croatia
- 2Department of Ophthalmology, Clinical Hospital Center Osijek, 31000 Osijek, Croatia
- 3Department of Ophthalmology, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
- 4TIM oftalmologija, 51000 Rijeka, Croatia
Abstract
Background and Objective: Uveitis occurs more frequently in multiple sclerosis (MS) than in the general population and is often clinically silent. We determined the anatomical types and visual field defect patterns of MS-associated uveitis, and compared the 24-month course of peripapillary retinal nerve fibre layer (pRNFL) thickness and perimetric mean defect (MD) between symptomatic and asymptomatic patients. Methods: Retrospective longitudinal study of 32 MS patients with uveitis diagnosed by SUN criteria, none with prior optic neuritis. Cirrus HD-OCT and Octopus 900 N1 perimetry were performed at three annual visits. Linear mixed models accounted for inter-eye correlation; annualized rates of change were calculated. Results: Uveitis was identified in 32 of 852 referred patients (3.8%). Intermediate uveitis predominated (59.4%). Fourteen patients (43.8%) were asymptomatic, yet visual field defects were present at baseline in 84.4% of the full cohort, despite generally preserved visual acuity. pRNFL declined in every subgroup (p < 0.0001), including non-inflamed fellow eyes. Within the bilateral uveitis subgroup (n = 24), thinning was faster in asymptomatic than symptomatic patients (−2.75 vs. −1.40 µm/year; Mann–Whitney p = 0.033), persisting in direction and magnitude after exclusion of three patients with cystoid macular oedema, although significance in that restricted sample was test-dependent (Mann–Whitney p = 0.054); the corresponding MD difference did not persist (p = 0.292). These symptom-based comparisons were exploratory. Conclusions: MS-associated uveitis is frequently asymptomatic but accompanied by subclinical perimetric loss, supporting examination irrespective of symptoms. pRNFL thinning was not confined to inflamed eyes; without an MS-without-uveitis or healthy comparator its origin cannot be attributed to a single mechanism. Structural and functional change dissociated.
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BibTeX
@article{vidovic2026dissociation,
title = {{Dissociation Between Progressive Retinal Nerve Fibre Layer Thinning and Perimetric Change in Multiple Sclerosis-Associated Uveitis}},
author = {Tomislav Vidović and Josip Knežević and Sonja Jandroković and Sanja Perić and Jelena Metikoš and Dina Lešin Gačina and Marija Bukvić and Tamara Mišljenović Vučerić},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15218376},
url = {https://www.mdpi.com/2077-0383/15/21/8376},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Dissociation Between Progressive Retinal Nerve Fibre Layer Thinning and Perimetric Change in Multiple Sclerosis-Associated Uveitis
AU - Tomislav Vidović
AU - Josip Knežević
AU - Sonja Jandroković
AU - Sanja Perić
AU - Jelena Metikoš
AU - Dina Lešin Gačina
AU - Marija Bukvić
AU - Tamara Mišljenović Vučerić
PY - 2026
DA - 2026/10/27
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218376
UR - https://www.mdpi.com/2077-0383/15/21/8376
AB - Background and Objective: Uveitis occurs more frequently in multiple sclerosis (MS) than in the general population and is often clinically silent. We determined the anatomical types and visual field defect patterns of MS-associated uveitis, and compared the 24-month course of peripapillary retinal nerve fibre layer (pRNFL) thickness and perimetric mean defect (MD) between symptomatic and asymptomatic patients. Methods: Retrospective longitudinal study of 32 MS patients with uveitis diagnosed by SUN criteria, none with prior optic neuritis. Cirrus HD-OCT and Octopus 900 N1 perimetry were performed at three annual visits. Linear mixed models accounted for inter-eye correlation; annualized rates of change were calculated. Results: Uveitis was identified in 32 of 852 referred patients (3.8%). Intermediate uveitis predominated (59.4%). Fourteen patients (43.8%) were asymptomatic, yet visual field defects were present at baseline in 84.4% of the full cohort, despite generally preserved visual acuity. pRNFL declined in every subgroup (p < 0.0001), including non-inflamed fellow eyes. Within the bilateral uveitis subgroup (n = 24), thinning was faster in asymptomatic than symptomatic patients (−2.75 vs. −1.40 µm/year; Mann–Whitney p = 0.033), persisting in direction and magnitude after exclusion of three patients with cystoid macular oedema, although significance in that restricted sample was test-dependent (Mann–Whitney p = 0.054); the corresponding MD difference did not persist (p = 0.292). These symptom-based comparisons were exploratory. Conclusions: MS-associated uveitis is frequently asymptomatic but accompanied by subclinical perimetric loss, supporting examination irrespective of symptoms. pRNFL thinning was not confined to inflamed eyes; without an MS-without-uveitis or healthy comparator its origin cannot be attributed to a single mechanism. Structural and functional change dissociated.
SN - 2077-0383
ER -