Color Vision Impairment Is Associated with Disease Severity in Multiple Sclerosis (P2.263)

Objective: To investigate the association between non-ON dyschromatopsia and Multiple Sclerosis (MS) severity. Background: Color vision assessment correlates with damage of the visual pathway and might be informative of overall brain damage in MS. Methods: We performed neurological and ophthalmic examinations and MRI and OCT analyses, on 108 MS patients, both at baseline and after a follow-up of 1 year. Color vision was evaluated by Hardy, Rand and Rittler plates. Dyschromatopsia was defined if color vision was impaired in either eye, except for participants with optic neuritis (ON), for whom only the unaffected eye was considered. We used general linear models adjusted for sex, age, disease duration and MS treatment for comparing disease severity and axonal damage markers among participants with and without dyschromatopsia. Results: Impaired color vision in non-ON eyes was detected in 21 out of 108 patients at baseline. At baseline, patients with dyschromatopsia had lower MSFC scores [adjusted difference:-0.25, 95%CI:-0.48 to -0.02;p=0.035] and BRB-N executive function scores [adjusted difference:-0.55, 95%CI:-1.00 to -0.10;p=0.016] than participants with normal color vision. In addition, these patients had thinner RNFL [adjusted difference:-8.72, 95%CI: -14.39 to -3.06;p=0.003], smaller macular volume [adjusted difference:-0.21, 95%CI:-0.39 to -0.03;p=0.025]; normalized brain volume [adjusted difference:-52.92, 95%CI:-92.51 to -13.33;p=0.009] and normalized grey matter volume (NGMV) [adjusted difference:-22.92, 95%CI:-47.59 to +1.74;p=0.069]. After 1-year follow-up, participants with incident dyschromatopsia had greater increase in EDSS score [adjusted-difference:0.52 95%CI: 0.21 to 0.81;p=0.001] and greater decrease in NGMV [adjusted-difference:19.38 95%CI: 5.57 to 33.19;p=0.006] than those with normal color vision. We evaluated the predictive value of incident dyschromatopsia and changes in markers of axonal loss on EDSS progression using standardized B coefficients of multivariate regression models. They were B=0.257 for incident dyschromatopsia and B=0.253 for NGMV change. Conclusions: Color vision impairment is associated with greater MS severity and may be a marker of future disability. Supported by ISCIII, Spain (FIS PS09/0025; RETICS RD07/0060/01), and Roche (RPF-ID046) Disclosure: Dr. Hernandez Martinez has received personal compensation for activities with Novartis, Biogen Idec, Teva Neuroscience, and Bayer Pharmaceuticals Corp. Dr. Ortiz has received personal compensation for activities with Novartis as a consultant. Dr. Fraga has nothing to disclose. Dr. Martinez-Heras has nothing to disclose. Dr. Gabilondo has received personal compensation for activities with Novartis. Dr. Llufriu Duran has received personal compensation for activities with Novartis, Biogen Idec, and Teva Neuroscience as a consultant. Dr. Bullich has nothing to disclose. Dr. Figueras-Roca has received personal compensation for activities with Bayer Pharmaceuticals Corp. and Bausch & Lomb. Dr. Saiz has received personal compensation for activities with Bayer Schering, Merck Serono, Biogen Idec, Sanofi-Aventis Pharmaceuticals Inc., Teva Neuroscience, and Novartis. Dr. Sanchez-Dalmau has received personal compensation for activities with Novartis. Dr. Villoslada has received personal compensation for activities with Roche Diagnostics Corp., Novartis, MedImmune, TFS, Heidelberg Engineering, Digna Biotech, and Neurotec Farma as a consultant, and with Novartis and Merck Serono as a founder. Dr. Villoslada holds stock and/or stock options in Bionure Farma SL which sponsored research in which Dr. Villoslada was involved as an investigator. Dr. Villoslada has received research support from Novartis, Roche Diagnostics Corp., and Genzyme Corp.