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Low-contrast visual acuity (LCVA) has emerged as a useful measure of visual dysfunction in patients with multiple sclerosis (MS) and in those with optic neuritis. LCVA has been shown to correlate well with attrition of retinal nerve fiber layers as seen on optical coherence tomography, and, increasingly, it is being used as an endpoint for treatment trials. However, the question remains whether it truly reflects disease burden. These researchers tested low- and high-contrast visual acuity binocularly in 45 patients with primarily relapsing-remitting MS and looked for correlations between acuity and lesion burden as measured by T2-weighted MRI.
On average, for every 1-line (5-letter) decrease in LCVA, there was a corresponding increase of 3 m…