Retinal damage and vision loss in African American multiple sclerosis patients

Dorlan J. Kimbrough, Elias S. Sotirchos, James A. Wilson, Omar Al-Louzi, Amy Conger, Darrel Conger, Teresa C. Frohman, Shiv Saidha, Ari J. Green, Elliot Frohman, Laura J. Balcer, Peter A. Calabresi

Research output: Contribution to journalArticlepeer-review

47 Scopus citations


Objective: To determine whether African American (AA) multiple sclerosis (MS) patients exhibit more retinal damage and visual impairment compared to Caucasian American (CA) MS patients. Methods: A total of 687 MS patients (81 AAs) and 110 healthy control (HC) subjects (14 AAs) were recruited at 3 academic hospitals between 2008 and 2012. Using mixed effects regression models, we compared high- and low-contrast visual acuity (HCVA and LCVA) and high-definition spectral domain optical coherence tomography measures of retinal architecture between MS patients of self-identified AA and CA ancestry. Results: In HCs, baseline peripapillary retinal nerve fiber layer (RNFL) thickness was 6.1μm greater in AAs (p50.047), whereas ganglion cell/inner plexiform layer (GCIP) thickness did not differ by race. In MS patients, baseline RNFL did not differ by race, and GCIP was 3.98μm thinner in AAs (p = 0.004). AAs had faster RNFL and GCIP thinning rates compared to CAs (p = 0.004 and p = 0.046, respectively). AA MS patients had lower baseline HCVA (p 5 0.02) and worse LCVA per year of disease duration (p = 0.039). Among patients with an acute optic neuritis (AON) history, AAs had greater loss of HCVA than CA patients (p = 0.012). Interpretation: This multicenter investigation provides objective evidence that AA MS patients exhibit accelerated retinal damage compared to CA MS patients. Self-identified AA ancestry is associated with worse MS-related visual disability, particularly in the context of an AON history, suggesting a more aggressive inflammatory disease course among AA MS patients or a subpopulation therein.

Original languageEnglish (US)
Pages (from-to)228-236
Number of pages9
JournalAnnals of Neurology
Issue number2
StatePublished - Feb 1 2015

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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