Tear Analysis in the Diagnosis of Multiple Sclerosis
Tear Analysis in the Diagnosis of Multiple Sclerosis
In the primary progressive multiple sclerosis, the detection of oligoclonal bands in
 cerebrospinal fluid is critical for the diagnosis. However, lumbar puncture for cerebrospinal
 fluid collection is considered relatively invasive. Our hypothesis is that oligoclonal bands
 detection in tears is possible and useful for the diagnosis of multiple sclerosis.
The objective of the present study is to assess concordance between oligoclonal bands
 detection in tears and in cerebrospinal fluid. We will include patients with primary
 progressive multiple sclerosis and we will compare results of oligoclonal bands detection by
 isoelectric focusing in cerebrospinal fluid and tears. Tears will be collected using a
 Schirmer strip. This would circumvent the practice of invasive lumbar punctures currently
 used in multiple sclerosis diagnosis.
Inclusion Criteria:

 -  18 years old or more

 -  Progressive neurological deficit after 12 months

 -  At least 9 T2 brain lesions of minimum 3 mm evidenced by MRI and/or four or more T2
 lesions of minimum 3 mm with positive Visual Evoked Potential and/or positive spinal
 cord MRI (at least two focal T2 lesions)

 Exclusion Criteria:

 -  Asiatic persons

 -  recurrent forms of the disease

 -  Persons wearing contact lenses

 -  Ocular Infection

 -  Corticoid treatment at least 30 days before sampling

 -  immunosuppressive or immunomodulatory treatment 3 months before sampling