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BRIEF RESEARCH REPORT article

Front. Immunol.
Sec. Multiple Sclerosis and Neuroimmunology
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1431394

Heterophoria in multiple sclerosis patients: a proof of principle cross-sectional study

Provisionally accepted
Jonas Graf Jonas Graf 1Margit Weise Margit Weise 1Tanja Guthoff Tanja Guthoff 2Carolin Balloff Carolin Balloff 1Marcia Gasis Marcia Gasis 1Heike Link Heike Link 3Sebastian Küchlin Sebastian Küchlin 3Wolf Lagrèze Wolf Lagrèze 3Sven Guenther Meuth Sven Guenther Meuth 1Orhan Aktas Orhan Aktas 1Philipp Albrecht Philipp Albrecht 1*
  • 1 Klinik für Neurologie, Universitätsklinikum Düsseldorf, Dusseldorf, Germany
  • 2 Department of Ophthalmology, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
  • 3 Department of Ophthalmology, Universitätsklinikum Freiburg, Freiburg, Germany

The final, formatted version of the article will be published soon.

    Objectives -The pathophysiology of multiple sclerosis (MS) involves inflammatory neurodegeneration in the brainstem, cerebellum and retina. The clinical relevance of oculomotor involvement in MS, however, remains uncertain.Methods -In this cross-sectional study, we evaluated heterophoria as a (sub)clinical tool in 54 MS patients and 55 age-matched healthy controls (HCs). We quantified heterophoria in prism diopters for distance and near range with orthoptic examination.Our primary outcome was high degrees of horizontal heterophoria (HDHH) defined as measurements beyond ±2 standard deviations from the mean prism diopter of heterophoria of our HCs.Results -More than one third (37%, n=20/54) of MS patients but only 11% (n=6/55) of HCs classified as HDHH (distance: MS=9% [n=5/54] versus HC=6% [n=3/55]; near: MS=19% [n=10/54] versus HC=5% [n=3/55]). Our MS patients presented more combined vertical and horizontal deviations at near (MS 19% [n=10/54] versus for HC 7% [n=4/55]). We observed the combination of HDHH both at distance and at near testing in 9% (n=5/54) of MS patients but not at all in HCs (n=0/55).Discussion -Despite the high prevalence of heterophoria, HDHH may be an additional (sub)clinical tool of subclinical involvement in MS. Thus, orthoptic examination may be an additional tool to improve MS diagnostic procedures.Author study concept/design, acquisition/survey/analysis/interpretation of data, drafting of the display items, drafting and revision of the manuscript TG Heinrich-

    Keywords: Multiple Sclerosis, Heterophoria, clinical assessment, screening, Orthoptic assessment

    Received: 11 May 2024; Accepted: 16 Jul 2024.

    Copyright: © 2024 Graf, Weise, Guthoff, Balloff, Gasis, Link, Küchlin, Lagrèze, Meuth, Aktas and Albrecht. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Philipp Albrecht, Klinik für Neurologie, Universitätsklinikum Düsseldorf, Dusseldorf, Germany

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