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Feb 2017
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Monitoring changes in MS with visual testing

Dr Joshua Barton, Brain and Mind Centre, University of Sydney, was awarded a Postgraduate Scholarship funded by the Trish MS Research Foundation.  Dr Barton’s supervisor is A/Prof Michael Barnett.

Highlights

·     * People with MS often have changes to their brains that appear before clinical symptoms of MS. Dr Barton is trialling a new method to track these ‘sub-clinical’ changes through the visual system using a computer tablet.

·     * Dr Barton has developed an ipad tool that is able to track changes in the visual system and will correlate these findings with any clinical changes seen using the standard measure of magnetic resonance imaging (MRI).

·     * The ipad tool is much faster than current methods and also allows people to test themselves, regardless of their location or ability to travel.

Progress to Date

In the first year of his PhD research, Dr Barton has developed an ipad based tool that is able to accurately measure an individual’s visual contrast sensitivity function. The benefit of this measure, as opposed to the traditional visual outcome measures used in clinical trials, is that the contrast sensitivity function encompasses both visual spatial sensitivity and visual contrast sensitivity. Dr Barton collaborated with the University of Sydney’s School of Information Technology to develop the ipad tool. 

The ipad tool is much faster than standard testing, taking approximately two minutes per eye tested and has the added benefit of being able to be used independently by patients. This allows home based self-testing by people with MS at a time that is convenient to them.

People with MS have been recruited to use the ipad tool to perform fortnightly self-assessments on their vision. These people will be tracked to determine whether any lesions develop using magnetic resonance imaging (MRI). The aim of this study is to detect any lesion development which is clinically silent, but that is able to be detected using the ipad tool. As yet, none of the people undertaking the iPad testing have shown any lesion development on MRI. This study is ongoing.

A second study will test the ability of the ipad tool to detect visual changes in people on MS medication alemtuzumab. This two year longitudinal study involving individuals treated alemtuzumab has been fully recruited and analysis of their visual data is ongoing.

During his research, Dr Barton has also developed a method for detecting the onset of the visual evoked potential (VEP). This is a measure of nerve speed in the visual system and is a considerable improvement on the current measures used as part of clinical trials and should provide an accurate assessment of nerve speed than currently available.

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