can occur as long as a year later, however ,some patients sustain permanent damage and can become blind. Acuity is variably diminished in the affected eye. A central or controcecal scotoma (marked enlargement of the blind spot to in volve central vision) can be documented. at the bedside with an Amsler grid, red desaturation can be demonstrated with color plates or with a red-tipped hat pin. Using the swinging, flashlight test in a darkened one can room , one can demonstrate a defect in the afferent pathway such that pupillary constriction in the affected eye is greater with contralateral than with direct light stimulus. A positive test reveals a relative afferent pupillary defect, sometimes called a Marcus Gunn pupil. Funduscopic examination is usually normal acute retrobulbar neuritis. When the optic nerve is affected anteriorly, the disc may be congested and swollen, thus resembling papilledema. Several months after an optic neuritis, the disc often appears pale, espdcially at the temporal border, and this can provide evidence of a previous attack. Occasionally, optic nerve demyelination and axonal damage can manifest. silently and is noticed only in the setting of other symptoms suggestive of MS.
A novel noninvasive eye scan called optical coherence tomography (OCT) is now being used to assess MS patients. The scan provides high-resolution quantifiable images of the retinal nerve fiber layer that have been shown in recent studies to reflect optic nerve damage even in asymptomatic eyes. OCT scans may prove to be very important biomarker for disease monitoring and therapeutic effectiveness ; howeves ,since OCT scans are not specifc for. MS/optic nerve pathology, they are not considered a diagnostic test to the exclusion of the thorough eye exam.
can occur as long as a year later, however ,some patients sustain permanent damage and can become blind. Acuity is variably diminished in the affected eye. A central or controcecal scotoma (marked enlargement of the blind spot to in volve central vision) can be documented. at the bedside with an Amsler grid, red desaturation can be demonstrated with color plates or with a red-tipped hat pin. Using the swinging, flashlight test in a darkened one can room , one can demonstrate a defect in the afferent pathway such that pupillary constriction in the affected eye is greater with contralateral than with direct light stimulus. A positive test reveals a relative afferent pupillary defect, sometimes called a Marcus Gunn pupil. Funduscopic examination is usually normal acute retrobulbar neuritis. When the optic nerve is affected anteriorly, the disc may be congested and swollen, thus resembling papilledema. Several months after an optic neuritis, the disc often appears pale, espdcially at the temporal border, and this can provide evidence of a previous attack. Occasionally, optic nerve demyelination and axonal damage can manifest. silently and is noticed only in the setting of other symptoms suggestive of MS. A novel noninvasive eye scan called optical coherence tomography (OCT) is now being used to assess MS patients. The scan provides high-resolution quantifiable images of the retinal nerve fiber layer that have been shown in recent studies to reflect optic nerve damage even in asymptomatic eyes. OCT scans may prove to be very important biomarker for disease monitoring and therapeutic effectiveness ; howeves ,since OCT scans are not specifc for. MS/optic nerve pathology, they are not considered a diagnostic test to the exclusion of the thorough eye exam.
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