Ocular Involvement Occurs Frequently at All Stages of Amyotrophic Lateral Sclerosis: Preliminary Experience in a Large Italian Cohort
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background and Purpose The study aimed to obtain optometric findings of amyotrophic lateral sclerosis (ALS) patients in different stages of the disease, and to determine the relation between ocular data and ALS-related features; that is, functional and cognitive impairment and staging. Methods The optometric protocol included tests of the ocular motility [broad-H test and Northeastern State University College of Optometry (NSUCO) test], near point of convergence (NPC), error refraction, best-corrected visual acuity, and binocular visual alignment, and an ocular symptoms questionnaire. The functional measures included the Amyotrophic Lateral Sclerosis Functional Rating Scale–revised (ALSFRS-r) and Milano-Torino staging (Mi- ToS), and cognitive impairment was assessed using the Edinburgh Cognitive and Behavioural ALS Screen (ECAS). Demographic and clinical features were also collected, including whether the patients used an eye-tracking communication device (ETCD). Results Two-hundred consecutive ALS patients (median age of 64 years, 118 males and 82 females) in different stages of disease were recruited. Nearly 70% of patients reported at least one ocular symptom, and the use of an ETCD was found to be significantly related to the presence of most symptoms. Moreover, the severely symptomatic group was characterized by significantly lower ALSFRS-r total and subscale scores, and higher MiToS. Abnormal NPC values were significantly related to lower ALSFRS-r total and bulbar-subscale scores. Patients with acceptable NSUCO test values exhibited significantly higher ECAS scores. Conclusions The presence of ocular alteration in patients in different stages of ALS supports the idea that this is a multisystem disorder and emphasizes the importance of optometric evaluations in multidisciplinary assessments to address ocular impairment early in the disease process
Abstract
Background and Purpose The study aimed to obtain optometric findings of amyotrophic lateral sclerosis (ALS) patients in different stages of the disease, and to determine the relation between ocular data and ALS-related features; that is, functional and cognitive impairment and staging. Methods The optometric protocol included tests of the ocular motility [broad-H test and Northeastern State University College of Optometry (NSUCO) test], near point of convergence (NPC), error refraction, best-corrected visual acuity, and binocular visual alignment, and an ocular symptoms questionnaire. The functional measures included the Amyotrophic Lateral Sclerosis Functional Rating Scale–revised (ALSFRS-r) and Milano-Torino staging (Mi- ToS), and cognitive impairment was assessed using the Edinburgh Cognitive and Behavioural ALS Screen (ECAS). Demographic and clinical features were also collected, including whether the patients used an eye-tracking communication device (ETCD). Results Two-hundred consecutive ALS patients (median age of 64 years, 118 males and 82 females) in different stages of disease were recruited. Nearly 70% of patients reported at least one ocular symptom, and the use of an ETCD was found to be significantly related to the presence of most symptoms. Moreover, the severely symptomatic group was characterized by significantly lower ALSFRS-r total and subscale scores, and higher MiToS. Abnormal NPC values were significantly related to lower ALSFRS-r total and bulbar-subscale scores. Patients with acceptable NSUCO test values exhibited significantly higher ECAS scores. Conclusions The presence of ocular alteration in patients in different stages of ALS supports the idea that this is a multisystem disorder and emphasizes the importance of optometric evaluations in multidisciplinary assessments to address ocular impairment early in the disease process
참고문헌 (40)
- Strong MJ, "Revisiting the concept of amyotrophic lateral sclerosis as a multisystems disorder of limited phenotypic expression", Curr Opin Neurol, 30, pp.599~607 (2017)
- Günther R, "Non-motor symptoms in patients suffering from motor neuron diseases", Front Neurol, 7, pp.117~ (2016)
- Neto LL, "Communication vulnerable in patients with amyotrophic lateral sclerosis : a systematic review", NeuroRehabilitation, 40, pp.561~568 (2017)
- Caligari M, "Eye tracking communication devices in amyotrophic lateral sclerosis : impact on disability and quality of life", Amyotroph Lateral Scler Frontotemporal Degener, 14, pp.546~552 (2013)
- Ohki M, "Ocular abnormalities in amyotrophic lateral sclerosis", Acta Otolaryngol Suppl, 511, pp.138~142 (1994)
- Palmowski A, "Eye movement in amyotrophic lateral sclerosis : a longitudinal study", Ger J Ophthalmol, 4, pp.355~362 (1995)
- Shaunak S, "Oculomotor function in amyotrophic lateral sclerosis : evidence for frontal impairment", Ann Neurol, 38, pp.38~44 (1995)
- Averbuch-Heller L, "Slow vertical saccades in motor neuron disease : correlation of structure and function", Ann Neurol, 44, pp.641~648 (1998)
- Donaghy C, "Eye movements in amyotrophic lateral sclerosis and its mimics : a review with illustrative cases", J Neurol Neurosurg Psychiatry, 82, pp.110~116 (2011)
- Donaghy C, "Slow saccades in bulbar-onset motor neurone disease", J Neurol, 257, pp.1134~1140 (2010)
- Sharma R, "Oculomotor dysfunction in amyotrophic lateral sclerosis : a comprehensive review", Arch Neurol, 68, pp.857~861 (2011)
- Gorges M, "Eye movement deficits are consistent with a staging model of pTDP-43 pathology in amyotrophic lateral sclerosis", PLoS One, 10, pp.e0142546~ (2015)
- Proudfoot M, "Eye-tracking in amyotrophic lateral sclerosis : a longitudinal study of saccadic and cognitive tasks", Amyotroph Lateral Scler Frontotemporal Degener, 17, pp.101~111 (2015)
- Ahmadi M, "Human extraocular muscles in ALS", Invest Ophthalmol Vis Sci, 51, pp.3494~3501 (2010)
- Simonett J, "Ocular manifestations and optic nerve changes in patients with amyotrophic lateral sclerosis(ALS)", Invest Ophthalmol Vis Sci, 54, pp.4382~ (2013)
- Simonett JM, "Macular sub-layer thinning and association with pulmonary function tests in amyotrophic lateral sclerosis", Sci Rep, 6, pp.29187~ (2016)
- Ringelstein M, "Subtle retinal pathology in amyotrophic lateral sclerosis", Ann Clin Transl Neurol, 1, pp.290~297 (2014)
- Roth NM, "Optical coherence tomography does not support optic nerve involvement in amyotrophic lateral sclerosis", Eur J Neurol, 20, pp.1170~1176 (2013)
- Fawzi AA, "Clinicopathologic report of ocular involvement in ALS patients with C9orf72 mutation", Amyotroph Lateral Scler Frontotemporal Degener, 15, pp.569~580 (2014)
- Volpe NJ, "Ophthalmic manifestations of amyotrophic lateral sclerosis (an American Ophthalmological Society thesis)", Trans Am Ophthalmol Soc, 113, pp.T12~ (2015)
- Ferrari G, "Corneal confocal microscopy reveals trigeminal small sensory fiber neuropathy in amyotrophic lateral sclerosis", Front Aging Neurosci, 6, pp.278~ (2014)
- Moss HE, "High and low contrast visual acuity are not affected in amyotrophic lateral sclerosis", PLoS One, 11, pp.e0168714~ (2016)
- Moss HE, "Cross-sectional evaluation of clinical neuro-ophthalmic abnormalities in an amyotrophic lateral sclerosis population", J Neurol Sci, 314, pp.97~101 (2012)
- Stefania Bona, "The development of an augmented reality device for the autonomous management of the electric bed and the electric wheelchair for patients with amyotrophic lateral sclerosis: a pilot study", Disability and Rehabilitation: Assistive Technology, 16(5), pp.513~519 (2021), Informa UK Limited[DOI]
- Brooks BR, "El Escorial revisited: revised criteria for the diagnosis of amyotrophic lateral sclerosis", Amyotroph Lateral Scler Other Motor Neuron Disord, 1, pp.293~299 (2000)
- Elliott DB, "Clinical Procedures in Primary Eye Care" (2008), Butterworth-Heinemann
- Maples WC, "Northeastern State University College of Optometry’s oculomotor norms", J Behav Optom, 3, pp.143~150 (1992)
- Scheiman M, "Clinical Management of Binocular Vision: Heterophoric, Accommodative and Eye Movement Disorders", pp.2014, Wolters Kluwer
- Ostadimoghaddam H, "The distribution of near point of convergence and its association with age, gender and refractive error : a population-based study", Clin Exp Optom, 100, pp.255~259 (2017)
- Bailey IL, "New design principles for visual acuity letter charts", Am J Optom Physiol Opt, 53, pp.740~745 (1976)
- Cedarbaum JM, "The ALSFRS-R : a revised ALS functional rating scale that incorporates assessments of respiratory function. BDNF ALS Study Group(Phase III)", J Neurol Sci, 169, pp.13~21 (1999)
- Franchignoni F, "Evidence of multidimensionality in the ALSFRS-R scale : a critical appraisal on its measurement properties using Rasch analysis", J Neurol Neurosurg Psychiatry, 84, pp.1340~1345 (2013)
- Franchignoni F, "A further Rasch study confirms that ALSFRS-R does not conform to fundamental measurement requirements", Amyotroph Lateral Scler Frontotemporal Degener, 16, pp.331~337 (2015)
- Chiò A, "Development and evaluation of a clinical staging system for amyotrophic lateral sclerosis", J Neurol Neurosurg Psychiatry, 86, pp.38~44 (2015)
- Poletti B, "The validation of the Italian Edinburgh Cognitive and Behavioural ALS Screen(ECAS)", Amyotroph Lateral Scler Frontotemporal Degener, 17, pp.489~498 (2016)
- "ALS: beyond the bucket. The ice bucket challenge was a sobering reminder of the deleterious effects of amyotrophic lateral sclerosis" (2014)[URL]
- Argilés M, "Blink rate and incomplete blinks in six different controlled hard-copy and electronic reading conditions", Invest Ophthalmol Vis Sci, 56, pp.6679~6685 (2015)
- 강봉희, "Abnormal Oculomotor Functions in Amyotrophic Lateral Sclerosis", Journal of Clinical Neurology, 14(4), pp.464~471 (2018), 대한신경과학회[DOI]
- Scudder CA, "The brainstem burst generator for saccadic eye movements : a modern synthesis", Exp Brain Res, 142, pp.439~462 (2002)
- Yunusova Y, "Clinical measures of bulbar dysfunction in ALS", Front Neurol, 10, pp.106~ (2019)