Low-contrast letter acuity testing captures visual dysfunction in patients with multiple sclerosis

M. L. Baier, G. R. Cutter, R. A. Rudick, D. Miller, J. A. Cohen, B. Weinstock-Guttman, Michele Mass, L. J. Balcer

Research output: Contribution to journalArticle

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Abstract

Objective: To evaluate concurrent and predictive validity for low-contrast letter acuity (L-CLA) testing as a candidate visual component for the Multiple Sclerosis Functional Composite (MSFC). Methods: L-CLA testing was conducted in two MS patient cohorts. In the MSFC Validation Study, 137 participants from a Phase III trial of inteferon beta-1a (Avonex) for relapsing-remitting MS were followed. A second cohort included 65 patients with secondary progressive MS who participated in a substudy of the International MS Secondary Progressive Avonex Controlled Trial (IMPACT). The total number of letters read correctly at four contrast levels (100, 5, 1.25, and 0.6%) was correlated with Expanded Disability Status Scale (EDSS), MSFC, Sickness Impact Profile, Multiple Sclerosis Quality of Life Inventory, and brain parenchymal fraction (BPF), as determined by MRI. Results: Low- and high-contrast letter acuity scores correlated with BPF at follow-up in the MSFC Validation Study (5%: r = 0.40, p <0.0001; 100%: r = 0.31, p = 0.0002). L-CLA also correlated with EDSS (5%: r = -0.35, p <0.0001; 1.25%: r = -0.26, p = 0.0003) and MSFC (5%: r = 0.47, p <0.0001; 1.25%: r = 0.45, p <0.0001). In the IMPACT Substudy, change in L-CLA scores from baseline to year 1 predicted subsequent change in the EDSS from year 1 to 2 at the 5% (p = 0.0142) and the 1.25% (p = 0.0038) contrast levels, after adjusting for change in MSFC scores from baseline to year 1. Conclusions: Low-contrast letter acuity (L-CLA) scores demonstrate concurrent and predictive validity in patients with relapsing-remitting and secondary progressive multiple sclerosis (MS). L-CLA testing provides additional information relevant to the MS disease process that is not entirely captured by the Multiple Sclerosis Functional Composite.

Original languageEnglish (US)
Pages (from-to)992-995
Number of pages4
JournalNeurology
Volume64
Issue number6
StatePublished - Mar 22 2005

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Multiple Sclerosis
Chronic Progressive Multiple Sclerosis
Validation Studies
Sickness Impact Profile
Relapsing-Remitting Multiple Sclerosis
Brain
Quality of Life
Equipment and Supplies

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Baier, M. L., Cutter, G. R., Rudick, R. A., Miller, D., Cohen, J. A., Weinstock-Guttman, B., ... Balcer, L. J. (2005). Low-contrast letter acuity testing captures visual dysfunction in patients with multiple sclerosis. Neurology, 64(6), 992-995.

Low-contrast letter acuity testing captures visual dysfunction in patients with multiple sclerosis. / Baier, M. L.; Cutter, G. R.; Rudick, R. A.; Miller, D.; Cohen, J. A.; Weinstock-Guttman, B.; Mass, Michele; Balcer, L. J.

In: Neurology, Vol. 64, No. 6, 22.03.2005, p. 992-995.

Research output: Contribution to journalArticle

Baier, ML, Cutter, GR, Rudick, RA, Miller, D, Cohen, JA, Weinstock-Guttman, B, Mass, M & Balcer, LJ 2005, 'Low-contrast letter acuity testing captures visual dysfunction in patients with multiple sclerosis', Neurology, vol. 64, no. 6, pp. 992-995.
Baier ML, Cutter GR, Rudick RA, Miller D, Cohen JA, Weinstock-Guttman B et al. Low-contrast letter acuity testing captures visual dysfunction in patients with multiple sclerosis. Neurology. 2005 Mar 22;64(6):992-995.
Baier, M. L. ; Cutter, G. R. ; Rudick, R. A. ; Miller, D. ; Cohen, J. A. ; Weinstock-Guttman, B. ; Mass, Michele ; Balcer, L. J. / Low-contrast letter acuity testing captures visual dysfunction in patients with multiple sclerosis. In: Neurology. 2005 ; Vol. 64, No. 6. pp. 992-995.
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abstract = "Objective: To evaluate concurrent and predictive validity for low-contrast letter acuity (L-CLA) testing as a candidate visual component for the Multiple Sclerosis Functional Composite (MSFC). Methods: L-CLA testing was conducted in two MS patient cohorts. In the MSFC Validation Study, 137 participants from a Phase III trial of inteferon beta-1a (Avonex) for relapsing-remitting MS were followed. A second cohort included 65 patients with secondary progressive MS who participated in a substudy of the International MS Secondary Progressive Avonex Controlled Trial (IMPACT). The total number of letters read correctly at four contrast levels (100, 5, 1.25, and 0.6{\%}) was correlated with Expanded Disability Status Scale (EDSS), MSFC, Sickness Impact Profile, Multiple Sclerosis Quality of Life Inventory, and brain parenchymal fraction (BPF), as determined by MRI. Results: Low- and high-contrast letter acuity scores correlated with BPF at follow-up in the MSFC Validation Study (5{\%}: r = 0.40, p <0.0001; 100{\%}: r = 0.31, p = 0.0002). L-CLA also correlated with EDSS (5{\%}: r = -0.35, p <0.0001; 1.25{\%}: r = -0.26, p = 0.0003) and MSFC (5{\%}: r = 0.47, p <0.0001; 1.25{\%}: r = 0.45, p <0.0001). In the IMPACT Substudy, change in L-CLA scores from baseline to year 1 predicted subsequent change in the EDSS from year 1 to 2 at the 5{\%} (p = 0.0142) and the 1.25{\%} (p = 0.0038) contrast levels, after adjusting for change in MSFC scores from baseline to year 1. Conclusions: Low-contrast letter acuity (L-CLA) scores demonstrate concurrent and predictive validity in patients with relapsing-remitting and secondary progressive multiple sclerosis (MS). L-CLA testing provides additional information relevant to the MS disease process that is not entirely captured by the Multiple Sclerosis Functional Composite.",
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T1 - Low-contrast letter acuity testing captures visual dysfunction in patients with multiple sclerosis

AU - Baier, M. L.

AU - Cutter, G. R.

AU - Rudick, R. A.

AU - Miller, D.

AU - Cohen, J. A.

AU - Weinstock-Guttman, B.

AU - Mass, Michele

AU - Balcer, L. J.

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N2 - Objective: To evaluate concurrent and predictive validity for low-contrast letter acuity (L-CLA) testing as a candidate visual component for the Multiple Sclerosis Functional Composite (MSFC). Methods: L-CLA testing was conducted in two MS patient cohorts. In the MSFC Validation Study, 137 participants from a Phase III trial of inteferon beta-1a (Avonex) for relapsing-remitting MS were followed. A second cohort included 65 patients with secondary progressive MS who participated in a substudy of the International MS Secondary Progressive Avonex Controlled Trial (IMPACT). The total number of letters read correctly at four contrast levels (100, 5, 1.25, and 0.6%) was correlated with Expanded Disability Status Scale (EDSS), MSFC, Sickness Impact Profile, Multiple Sclerosis Quality of Life Inventory, and brain parenchymal fraction (BPF), as determined by MRI. Results: Low- and high-contrast letter acuity scores correlated with BPF at follow-up in the MSFC Validation Study (5%: r = 0.40, p <0.0001; 100%: r = 0.31, p = 0.0002). L-CLA also correlated with EDSS (5%: r = -0.35, p <0.0001; 1.25%: r = -0.26, p = 0.0003) and MSFC (5%: r = 0.47, p <0.0001; 1.25%: r = 0.45, p <0.0001). In the IMPACT Substudy, change in L-CLA scores from baseline to year 1 predicted subsequent change in the EDSS from year 1 to 2 at the 5% (p = 0.0142) and the 1.25% (p = 0.0038) contrast levels, after adjusting for change in MSFC scores from baseline to year 1. Conclusions: Low-contrast letter acuity (L-CLA) scores demonstrate concurrent and predictive validity in patients with relapsing-remitting and secondary progressive multiple sclerosis (MS). L-CLA testing provides additional information relevant to the MS disease process that is not entirely captured by the Multiple Sclerosis Functional Composite.

AB - Objective: To evaluate concurrent and predictive validity for low-contrast letter acuity (L-CLA) testing as a candidate visual component for the Multiple Sclerosis Functional Composite (MSFC). Methods: L-CLA testing was conducted in two MS patient cohorts. In the MSFC Validation Study, 137 participants from a Phase III trial of inteferon beta-1a (Avonex) for relapsing-remitting MS were followed. A second cohort included 65 patients with secondary progressive MS who participated in a substudy of the International MS Secondary Progressive Avonex Controlled Trial (IMPACT). The total number of letters read correctly at four contrast levels (100, 5, 1.25, and 0.6%) was correlated with Expanded Disability Status Scale (EDSS), MSFC, Sickness Impact Profile, Multiple Sclerosis Quality of Life Inventory, and brain parenchymal fraction (BPF), as determined by MRI. Results: Low- and high-contrast letter acuity scores correlated with BPF at follow-up in the MSFC Validation Study (5%: r = 0.40, p <0.0001; 100%: r = 0.31, p = 0.0002). L-CLA also correlated with EDSS (5%: r = -0.35, p <0.0001; 1.25%: r = -0.26, p = 0.0003) and MSFC (5%: r = 0.47, p <0.0001; 1.25%: r = 0.45, p <0.0001). In the IMPACT Substudy, change in L-CLA scores from baseline to year 1 predicted subsequent change in the EDSS from year 1 to 2 at the 5% (p = 0.0142) and the 1.25% (p = 0.0038) contrast levels, after adjusting for change in MSFC scores from baseline to year 1. Conclusions: Low-contrast letter acuity (L-CLA) scores demonstrate concurrent and predictive validity in patients with relapsing-remitting and secondary progressive multiple sclerosis (MS). L-CLA testing provides additional information relevant to the MS disease process that is not entirely captured by the Multiple Sclerosis Functional Composite.

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