Visual signs and symptoms of multiple system atrophy

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Authors

  • Richard A. Armstrong

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Abstract

Multiple system atrophy (MSA) is a rare movement disorder and a member of the 'parkinsonian syndromes', which also include Parkinson's disease (PD), progressive supranuclear palsy (PSP), dementia with Lewy bodies (DLB) and corticobasal degeneration (CBD). Multiple system atrophy is a complex syndrome, in which patients exhibit a variety of signs and symptoms, including parkinsonism, ataxia and autonomic dysfunction. It can be difficult to separate MSA from the other parkinsonian syndromes but if ocular signs and symptoms are present, they may aid differential diagnosis. Typical ocular features of MSA include blepharospasm, excessive square-wave jerks, mild to moderate hypometria of saccades, impaired vestibular-ocular reflex (VOR), nystagmus and impaired event-related evoked potentials. Less typical features include slowing of saccadic eye movements, the presence of vertical gaze palsy, visual hallucinations and an impaired electroretinogram (ERG). Aspects of primary vision such as visual acuity, colour vision or visual fields are usually unaffected. Management of the disease to deal with problems of walking, movement, daily tasks and speech problems is important in MSA. Optometrists can work in collaboration with the patient and health-care providers to identify and manage the patient's visual deficits. A more specific role for the optometrist is to correct vision to prevent falls and to monitor the anterior eye to prevent dry eye and control blepharospasm.

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  • Visual signs and symptoms of multiple system atrophy

    Rights statement: This is the peer reviewed version of the following article: Armstrong, R. A. (2014). Visual signs and symptoms of multiple system atrophy. Clinical and experimental optometry, 97(6), 483-491, which has been published in final form at http://dx.doi.org/10.1111/cxo.12206. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.

    Accepted author manuscript, 511 KB, PDF-document

Details

Original languageEnglish
Pages (from-to)483-491
Number of pages9
JournalClinical and Experimental Optometry
Volume97
Issue number6
Early online date25 Sep 2014
DOIs
Publication statusPublished - 1 Nov 2014

Bibliographic note

This is the peer reviewed version of the following article: Armstrong, R. A. (2014). Visual signs and symptoms of multiple system atrophy. Clinical and experimental optometry, 97(6), 483-491, which has been published in final form at http://dx.doi.org/10.1111/cxo.12206. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.

    Keywords

  • autonomic dysfunction, dementia with lewy bodies, multiple system atrophy, Parkinsonism, progressive supranuclear palsy

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