Investigation of Afferent Visual Pathway Analyzing Neurodegenerative Process in Multiple Sclerosis Patients. Summary of the Doctoral Thesis

Abstract

Multiple sclerosis is a chronic autoimmune, demyelinating and neurodegenerative disease of the central nervous system. There are more than two million multiple sclerosis patients in the world, and it is the most common cause of non-traumatic disability in young people. Despite extensive research, the pathogenesis of multiple sclerosis is still not clear. In addition, this disease is not fully curable and its progress for each individual patient is unpredictable. There is increasing need for biological markers with the purpose to categorize patients, to predict and monitor the course of the disease, as well as to intend and monitor the effectiveness of treatment. Multiple sclerosis often causes visual disturbances. The doctoral thesis “Use of afferent visual pathway for analysis of neurodegenerative processes in multiple sclerosis patients” is devoted to investigation of the afferent visual pathway as a clinical model of multiple sclerosis. Significant advantage of the afferent visual pathway is that it is available for detailed and direct structural and functional studies. Afferent visual pathway in the case of acute optic neuritis represents an acute central nervous system lesion, but in the subclinical, chronic retinopathy and optic neuropathy cases it represents a diffuse, chronic damage caused by multiple sclerosis. The aim was to study the significance of changes in afferent visual pathway regarding the evaluation of neurodegenerative processes caused by multiple sclerosis. In the research neurological, ophthalmologic and radiological examinations for 76 relapsing-remitting multiple sclerosis patients with and without optic neuritis signs in history were conducted. The research results indicate that there are detectable changes in the afferent visual system in multiple sclerosis patients unrelated to previous clinical optic neuritis episode. These changes are both functional and structural, and their mutual correlation is observed. In addition, neurodegenerative changes in the afferent visual system are correlated with disease duration, degree of disability, as well as the number and the localization of demyelinating lesions in the brain, and brain atrophy. In the study the best method of clinical optic neuritis approval was established, as well as the model of the retinal nerve fiber layer damage prediction was developed using functional investigation methods. It was elucidated that the afferent visual system characterizing parameters can be used to obtain information on the subclinical neurodegenerative processes.