We report clinical features of ocular symptoms in 80 patients with
multiple sclerosis (MS). Serial 80 patients with MS had been admitted to our Neurology Ward at Nihon University Itabashi Hospital from April 1980 to October 2003. All patients were also examined by our neuro-ophthalmologists. Ocular symptoms were observed in 49 patients, and 14 patients were male and 35 were female. Patients' age at onset varied from 17 to 51 years old, with the average being 31.2 +/- 4.2 years. Observation period were 6 months to15 years, and average 5.4 +/- 1.4 years. In visual symptoms, retrobulbar
optic neuritis was observed in 33 eyes of 26 patients. On the first attack of retrobulbar
optic neuritis, 25 eyes showed a corrected visual acuity of less than 0.1. After
corticosteroid therapy, a corrected visual acuity improved more than 1.0 in 17 eyes.
Optic atrophy was observed in 22 eyes and
color blindness in 16 eyes. On the second attack of retrobulbar
optic neuritis on the same eyes, 6 of 9 eyes showed a corrected visual acuity of less than 0.1 after
corticosteroid therapy.
Optic atrophy and
color blindness were confirmed in all eyes.
Homonymous hemianopia was detected in 2 female patients and completely resolved after
corticosteroid therapy. On the other hand, ocular motor symptoms were observed in 29 patients.
Internuclear ophthalmoplegia was detected in 18 patients, nystagmus in 5,
abducens nerve palsy in 5,
skew deviation in 5, one-and-a-half syndrome in 2, gaze
palsy in 2 and ocular
myoclonus in 1. In all except one patient with primary position downbeat nystagmus, ocular
myoclonus and bilateral
internuclear ophthalmoplegia, these symptoms improved completely within 8 weeks after
corticosteroid therapy. We emphasize that cooperation of neurologist and ophthalmologist plays an important role for clinical evaluation of MS patients.