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Sensitivity of visual evoked potentials and spectral domain optical coherence tomography in early relapsing remitting multiple sclerosis

Multiple Sclerosis and Related Disorders, Volume 12, February 2017, Pages 15-19

Abstract

Background

Visual evoked potentials and spectral-domain optical coherence tomography are common ancillary studies that assess the visual pathways from a functional and structural aspect, respectively.

Objective

To compare prevalence of abnormalities of Visual evoked potentials (VEP) and spectral-domain optical coherence tomography (SDOCT) in patients with relapsing remitting multiple sclerosis (RRMS).

Methods

A cross-sectional study of 100 eyes with disease duration of less than 5 years since the diagnosis. Correlation between retinal nerve fiber layer and ganglion-cell/inner plexiform layer with pattern-reversal visual evoked potentials amplitude and latency and contrast sensitivity was performed.

Results

The prevalence of abnormalities in pattern-reversal visual VEP was 56% while that of SOCT was 48% in all eyes. There was significant negative correlations between the average RNFL (r=−0.34, p=0.001) and GCIPL (r=−0.39, p<0.001) with VEP latency. In eyes with prior optic neuritis, a significant negative correlation was seen between average RNFL (r=−0.33, p=0.037) and GCIPL (r=−0.40, p=0.010) with VEP latency.

Conclusions

We have found higher prevalence of VEP abnormalities than SCOCT in early relapsing-remitting multiple sclerosis. This suggests that VEP has a higher sensitivity for detecting lesions of the visual pathway in patients with early RRMS.

Highlights

  • We have compared Spectral Domain Optical Coherence Tomography to Visual-evoked potentials in early relapsing remitting multiple sclerosis (less than 5 years since diagnosis).
  • Visual Evoked Potentials showed higher prevalence of abnormalities compared to Spectral Domain Optical Coherence Tomography.
  • There was significant negative correlation between the latency of Visual Evoked Potentials and retinal nerve fiber layer thickness and the ganglion cell/inner plexiform layer.
  • Visual Evoked Potentials may be more sensitive in detecting occult visual pathway lesions in early relapsing remitting multiple sclerosis.

Keywords: Optical coherence tomography, Retinal nerve fiber layer, Ganglion cell/inner plexiform layer, Multiple sclerosis, Axonal loss, Visual evoked potentials.

Footnotes

a Opthalmology Clinic, Dasman Institute, Dasman, Kuwait

b Al-Bahar Ophthalmology Center, Ibn Sina Hospital, Kuwait

c Department of Neurology, Ibn Sina Hospital, Kuwait

d Department of Neurology and Psychiatry, Minia University, Egypt

e Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait

f Division of Neurology, Amiri Hospital, Sharq, Kuwait

Correspondence to: FRCSC, P.O Box 1180, Dasman 15462, Kuwait.