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Affection of the optic nerves play a central role in multiple sclerosis (MS) symptomatology. In reported autopsy series the prevalence of optic neuropathy has approached 100%. In the present study subclinical affection of the optic nerves was investigated by visual evoked response (VER), Farnworth-Munsell 100 Hue test (FM 100 Hue test) and Ishihara plates in 17 patients with normal visual acuity and without a history of acute optic neuritis. Optic neuropathy was demonstrated in 72% of the eyes. The occurrence of optic neuropathy was also investigated by the same methods in 16 patients with previous acute optic neuritis, which was bilateral in 5 patients. Affection of the optic nerves was demonstrated in 95% in this group. The affection of also the fellow eye in patients with previous monolateral optic neuritis is unexplained. It may be an analogue to the symmetry of plaques found in the brain and the spinal cord. The cause of this peculiar distribution of lesions is, like the ethiology of MS, unexplained at present. In compairing the different methods of demonstrating optic neuropathy, VER is recommended as the method of choice.

The reported findings of periphlebitis retinae (PR) at autopsy, in which brain autopsy was also performed, in 2 patients with multiple sclerosis (MS) are, so far as the authors are aware, the first histological account of this manifestation of the disease. The similarity between the cellular accumulations around the veins of the central nervous system seen in multiple sclerosis and the periphlebitic cellular accumulations here described suggests that periphlebitis is an initial event in plaque formation.

Periphlebitis retinae (PR) in multiple sclerosis (MS) is seen as cuffs around veins in the otherwise normal retinae. The frequency of PR in MS varies considerably between different series, approximately from 5 to 25%. The aim of the present study was to investigate if PR, when present, is correlated to neurological disease activity. No similar study has been performed to the author's knowledge. The prevalence of PR in a hospital material of 135 MS patients was 15%, compared to the frequency of 5% found in 168 MS patients examined at a Rehabilitation Center. Thus a three times higher frequency was found in the hospital material which comprised more patients with active disease. The status of neurological disease activity was assessed in 27 patients at the occurrence of PR. One patient only had stationary disease. The frequency of malignant MS in the 27 PR patients was 26% versus 9%. The present study suggests a correlation between neurological disease activity and PR in MS patients.

— Periphlebitis retinae (PR) in multiple sclerosis (MS) is seen as transitory infiltrations around veins in the otherwise normal retina. Cellular infiltrations have been found around veins in the central nervous system (CNS), where it has been suggested that they are the first event in plaque formation. Technetium brain scans are usually normal in MS patients, but transitory abnormal scans of the cerebrum have been found in MS patients during acute attack or exacerbation. In order to test the hypothesis that active PR is a sign of simultaneous disease activity in the CNS, 29 technetium brain scans were carried out on 14 MS patients with active PR and on 15 MS patients without any signs of PR. Significantly more of the patients with active PR, compared with MS patients with previous PR, displayed abnormal brain scans. This indicates that a disruption of the blood brain barrier (BBB) and active PR occur simultaneously in MS.

The first authors who described periphlebitis retinae (PR) in multiple sclerosis (MS) suggested that PR and MS plaques had a common aetiology. This has never been investigated. To see if further research is warranted, the literature on PR in MS was reviewed. A statistical analysis was set up based on frequency and duration of PR in MS in previously published articles. The result was that it is probable that PR affects all MS patients, and it is also probable that PR may recur. Further studies of PR in MS are thus indicated.

Periphlebitis retinae in multiple sclerosis appears as transitory cellular infiltrations around veins in an otherwise normal retina. Similar cellular infiltrations have been found around veins in the central nervous system. In the present study the blood-retinal barrier has been investigated by vitreous fluorophotometry. Eight multiple sclerosis patients with actual periphlebitis retinae and 9 patients with previous but not active periphlebitis retinae were included in this study. Abnormal leakage of fluorescein was manifest in the group of multiple sclerosis patients with periphlebitis retinae. Permeability (1.8 +/- 0.2 X 10(-7) cm/sec; mean +/- SEM) but not in the control group as a whole permeability (1.3 +/- 0.1 X 10(-7) cm/sec; mean +/- SEM) compared to 17 normals (permeability 1.1 +/- 0.005). It is thus concluded that breakdown of the blood-retinal barrier may be transitory when connected with periphlebitis retinae in multiple sclerosis.

Periphlebitis retinae (PR) in multiple sclerosis (MS) is defined as ophthalmoscopically visible cuffs around veins in the otherwise normal retina. PR in MS has been suggested to be of a recurring nature, but to the authors knowledge this is the first study in which PR in MS has been seen to recur. A recurrence of PR in MS reflects the neurological progress. The material is unique because of the span of years these patients have been followed. In the 4 patients here presented the interval between the two episodes of PR was 16, 13, 5 and 0.5 years, respectively.

Age at onset, debut symptoms, optic nerve signs, and severity of symptoms were evaluated from the medical records of 135 patients with MS. HLA-D/DR2 was significantly more frequent in rapidly progressive MS, and D/DR2 seemed to confer both susceptibility to the disease and to more rapid progression. However, D/DR3 seemed to protect against rapid progression.