UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Validity of low-contrast letter acuity as a visual performance outcome measure for multiple sclerosis.

Balcer, LJ; Raynowska, J; Nolan, R; Galetta, SL; Kapoor, R; Benedict, R; Phillips, G; ... Multiple Sclerosis Outcome Assessments Consortium; + view all (2017) Validity of low-contrast letter acuity as a visual performance outcome measure for multiple sclerosis. Multiple Sclerosis Journal , 23 (5) pp. 734-747. 10.1177/1352458517690822. Green open access

[thumbnail of 1352458517690822.pdf]
Preview
Text
1352458517690822.pdf - Published version

Download (570kB) | Preview

Abstract

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.

Type: Article
Title: Validity of low-contrast letter acuity as a visual performance outcome measure for multiple sclerosis.
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1177/1352458517690822
Publisher version: https://doi.org/10.1177/1352458517690822
Language: English
Additional information: © The Author(s), 2017. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Keywords: Multiple sclerosis, function, low-contrast letter acuity, optical coherence tomography, quality of life, vision
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
URI: https://discovery.ucl.ac.uk/id/eprint/1542405
Downloads since deposit
137Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item