Ocular manifestations in patients with multiple sclerosis in São Paulo

Purpose: To study the frequency and characteristics of ocular manifestations in patients with multiple sclerosis (MS) in the state of São Paulo. Methods: From March, 1996 to November, 1998, 64 patients (48 females, 16 males, age 17 59 years) with MS underwent ophthalmologic examination and computerized visual field perimeter testing. Results: Forty-four (68.75%) of the 64 examined patients presented some kind of ocular manifestation. The most frequent manifestation was optic neuritis (28 patients 43.75%). It was the first manifestation of MS in 18 (28.1%) patients. Alterations of ocular motility were the second most frequent finding. Eight (12.5%) patients suffered from diplopia, of which 6 (9.37%) presented this as their first manifestation of MS. Sixth nerve palsy occurred in 2 patients (3.1%), with esotropia as a first sign of the disease. Other findings can be listed: uveitis (4 patients 6.25%), changes in iridian topography with anterior lens capsule pigmentation (3 patients 4.6%). The most frequent visual field defect in the patients who presented optic neuritis was arcuate scotoma with paracentral defects (46.4%). Two patients presented central scotomas and peripheral changes. None of the patients presented nystagmus. Conclusion: Our data show that ocular findings in MS are frequent and many times are the initial manifestation of this disease. Although optic neuritis was the most frequent finding, we must emphasize the possibility of other ocular manifestations to be either preceding or occuring at the same time as this disease. Manifestações oculares em pacientes com esclerose múltipla em São Paulo