Does Multiple Sclerosis Cause Macular Degeneration?

Multiple Sclerosis (MS) is an autoimmune condition affecting both the brain and spinal cord. The severity of symptoms varies significantly from person to person and may last days or even years before worsening over time.

MS damages the myelin coating that surrounds nerves in the brain. MS nibbles away at this protective covering, exposing nerve energy and its strength to further harm.

Causes

Multiple Sclerosis affects myelinated areas of the central nervous system, including optic nerves and the uvea (eye), which may result in damage to both retinas and optic nerves, leading to visual impairment and blindness in patients with MS. OCT (Optical Coherence Tomography) imaging technology offers an advanced solution that measures and monitors the health of optic nerves and retinas as well as detect any irreversible axonal loss – an invaluable factor when predicting long-term disability.

MS macular degeneration is caused by atrophy of retinal nerve fiber layer, due to inflammation of optic nerve, which serves as an electrical wire between retina and brain, carrying visual information. If its fibers become swollen and inflamed, vision becomes fuzzy – an inflammation known as optic neuritis which may eventually result in permanent vision loss in either eye.

Damage to myelin sheaths of axons makes them incapable of transmitting signals properly, leading to dim and blurry vision. OCT images allow clinicians to monitor progress of thinning and axonal loss over time and plan for effective interventions to maintain vision quality over time.

OCT measurements can assess the health of macula by monitoring changes to macular nerve fiber layer thickness – an indicator of potential axonal loss.

The study discovered that MS patients had thinner retinal nerve fiber layers (pRNFL) compared with controls, particularly around the macular area. Ocular nerve fiber layer and macular ganglion cell + inner plexiform layers also appeared thinner for those without prior history of optic neuritis. Furthermore, early-on axonal losses become irreparable during disease progression.

Researchers suggest this could be an indicator of either relapse or the beginning of secondary progressive MS, with symptoms including worsening vision and an increased risk for wet age-related macular degeneration (AMD), where abnormal blood vessels form under the retina and leak, leading to blindness in central areas known as maculae. Anti-VEGF therapy has proven highly successful at stopping its progress and restoring vision.

Symptoms

The macula is a tiny part of your retina at the back of your eye that provides you with central vision – the ability to see fine details and colors clearly. There are two main forms of macular degeneration: dry and wet. With dry macular degeneration, abnormal deposits of yellow pigment known as drusen form underneath your retina which eventually break down light-sensitive cells resulting in blurred or distorted central vision; often this form of AMD does not produce any noticeable symptoms so many do not realize they have it until they visit an ophthalmologist for examination of their eyes.

As AMD progresses to wet AMD, abnormal blood vessels may form beneath your retina near the macula and leak or bleed onto retinal photoreceptors, leading to rapid and severe vision loss – especially straight-ahead (straight-line) vision loss. Wet macular degeneration symptoms include blurred or blind spots in central vision; discolored colors; distortion of straight objects and distortion. It is much less frequent than dry AMD however.

Although macular degeneration cannot be prevented entirely, research suggests that eating foods rich in certain nutrients may slow its progress. This includes vitamins A, C and E as well as zinc and antioxidants lutein and zeaxanthin which protect against damage caused by oxygen-charged molecules (free radicals) known to exacerbate macular degeneration – you’ll find these antioxidants in foods like kale, raw spinach and collard greens as well as nutritional supplements.

Researchers have also discovered that those living with multiple sclerosis display different patterns of macular thinning than people without multiple sclerosis, lending credence to the theory that neurodegeneration causes this effect. Their analysis involved measuring macula thickness between fifteen patients with MS and fifteen age-matched control subjects using optical coherence tomography device analysis – they observed thinner thickness in MS patient’s central region and outer part than healthy control subjects.

Diagnosis

Multiple Sclerosis (MS) occurs when the immune system attacks its own tissues mistakenly, disrupting nerve signals from traveling from one brain cell to the next and potentially altering information processing in certain parts of the brain. Susceptibility appears to have genetic ties; those with close relatives living with MS have an increased chance of contracting it themselves.

MS is diagnosed using signs and symptoms, radiographic findings and laboratory testing. Unfortunately, its early symptoms may resemble other illnesses; however, a thorough physical exam can often reveal MS as the source. Some telltale signs may include asymmetrical vision loss, optic neuritis, spasticity or weakness as well as changes in how people think.

While a cure for multiple sclerosis has yet to be discovered, research into it has brought us one step closer to developing treatments that will slow its progress and lessen symptoms. Medication currently available can help control symptoms and enhance quality of life for people living with MS. Therefore it is advisable to discuss medication options with healthcare providers when managing MS.

At First Choice Neurology, our primary mission is providing tailored care for people living with multiple sclerosis and other neurological conditions. By combining expertise with state-of-the-art facilities and an individualized approach, we aim to maximize quality of life for those affected by disabling diseases like multiple sclerosis. Contact us now to discover more of what services we provide – we look forward to meeting you!

Treatment

MS is a condition in which the immune system attacks healthy tissue in the central nervous system – brain and spinal cord. This results in inflammation that breaks down myelin sheath protection on nerve fibers, leading to loss of function of parts of the central nervous system. Individual symptoms vary; from fatigue, numbness and tingling of hands and feet, muscle weakness or spasticity to bladder or bowel problems and memory issues for people living with MS.

Relapsing-remitting multiple sclerosis (RMS) is characterized by episodes of exacerbated symptoms, known as relapses, followed by periods of recovery called remissions. People living with primary progressive MS are experiencing steadily worsening conditions.

While MS symptoms can affect anyone, certain factors increase one’s risk. People of white ancestry are more likely to develop it than people from other races; those with family histories of thyroid disease, pernicious anemia, psoriasis or type 1 diabetes have an increased chance of contracting the condition; people living in colder climates also stand a greater chance.

Optic neuritis, which results in complete and permanent blindness in one eye, occurs in up to 20% of people living with MS, and may indicate their disease is worsening or they have an infection such as viral or bacterial in the cerebrospinal fluid.

Your health care provider will ask about your symptoms and perform an examination using an Amsler grid chart to check for changes to the center of your field of vision. An ophthalmologist may also use a bright light on the back of the eye to test your ability to distinguish shapes and colors by shining it upon it.

There are various things you can do to help manage the symptoms of macular degeneration and multiple sclerosis. Diet can play an integral part in this effort; one should prioritize eating foods rich in vitamins and minerals that contain antioxidants – chemicals that protect from damage caused by free radicals – such as lutein and zeaxanthin, two antioxidants found naturally within macula cells as well as in green vegetables like kale, raw spinach and collards – plus nutritional supplements.