P30.14 Long term follow-up of visual evoked potential parameters in patients with multiple sclerosis

Introduction: Optic neuritis is an inflammation of the optic nerve that usually affects young females. In Western countries, natural history and treatment of optic neuritis(ON) has been studied extensively. However aetiology, natural history, clinical features of ON and their relation to multiple sclerosis in Asian population needs to be defined yet. Methods: 30 patients who were diagnosed as optic neuritis were included between June 2013 to December 2014 at BP Koirala Lions Centre for Ophthalmic Studies (BPKLCOS). A detailed history was obtained followed by examination of anterior and posterior segment. Assessment of visual acuity, color vision, contrast sensitivity, visual evoked potential (VEP),visual field and MRI of orbit and brain was done in all cases. All patients were treated with intravenous Methylprednisolone 500mg twice daily for 3 days followed by oral steroid for 11 days which was tapered in the next 4 days.The patients were reassessed at 2 weeks, 1 month and 3months. Results: Commonest presenting symptom was diminution of vision(65%). MRI showed multiple paraventricular oval plaques definite of multiple sclerosis in one patient and one was diagnosed as probable MS who had a single periventricular plaque. Visual evoked potential (VEP) showed increase in the mean P100 latency at 60’ and reduction in amplitude in eyes affected with optic neuritis compared to normal eyes. At 3 months follow up, 70% had good visual recovery (>6/18). The cause of non-improvement in vision was disc pallor. Optic disc pallor was detected in 37.5% of the eyes during follow up. Conclusions: Good visual recovery was observed in most eyes with acute optic neuritis. Multiple sclerosis was seen in 1 patient who had recurrent optic neuritis.

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Evolution of Visual Evoked Potentials in Optic Neuritis

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100028110 ◽

1988 ◽

Vol 15 (4) ◽

pp. 394-396 ◽

Cited By ~ 9

Author(s):

Irvin H. Heinrichs ◽

Donald R. McLean

Keyword(s):

Multiple Sclerosis ◽

Optic Neuritis ◽

Visual Evoked Potentials ◽

Visual Evoked Potential ◽

Evoked Potential ◽

Clinical Evidence ◽

Initial Examination ◽

Vep Latency ◽

Visual Evoked

ABSTRACT:The visual evoked potential (VEP) latency was either abnormally prolonged or absent in the involved eye of 47 patients with optic neuritis. Twenty-two of these patients with known multiple sclerosis (MS), had similar abnormalities to 25 patients with no clinical evidence of MS. Follow-up clinical assessment and VEP were done 10 to 42 (mean 22) months later in 34 patients. In 15 of 34 patients with no VEP from the involved eye during initial examination, 6 returned to normal, 8 had prolonged latencies and 1 still had no response at follow up. Of 19 patients who initially had prolonged latencies in the involved eye, 6 returned to normal, 11 had prolonged latencies and 2 had no response at follow up. The VEP is helpful in confirming the diagnosis of ON. The examination must be performed when the patient is symptomatic or soon thereafter as 35% of our patients with an abnormal initial VEP had a normal VEP at follow up. This normalization was not related to the severity of the initial VEP abnormality.

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A Preliminary Investigation into the Relationship between Visual Evoked Potential Latency (VEP-L) and Outcome Parameters from Optical Coherence Tomography (OCT) in People with Multiple Sclerosis

10.26226/morressier.59a3edabd462b8028d894e11 ◽

2017 ◽

Author(s):

Mark Gudesblatt

Keyword(s):

Multiple Sclerosis ◽

Optical Coherence Tomography ◽

Visual Evoked Potential ◽

Evoked Potential ◽

Preliminary Investigation ◽

Optical Coherence ◽

Outcome Parameters ◽

The Relationship ◽

Visual Evoked

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Disability improvement as a clinically relevant outcome in clinical trials of relapsing forms of multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/13524585211000280 ◽

2021 ◽

pp. 135245852110002

Author(s):

Bruce AC Cree ◽

Jeffrey A Cohen ◽

Anthony T Reder ◽

Davorka Tomic ◽

Diego Silva ◽

...

Keyword(s):

Multiple Sclerosis ◽

Clinical Trials ◽

Therapeutic Benefit ◽

Disease Modifying Therapies ◽

Long Term Follow Up ◽

Post Hoc ◽

Switch Group ◽

Relevant Outcome

Background: Disease-modifying therapies (DMTs) can reduce the risk of disability worsening in patients with relapsing forms of multiple sclerosis (RMS). High-efficacy DMTs can lead to confirmed or sustained disability improvement (CDI and SDI). Objective and Methods: Post hoc analyses of data from the TRANSFORMS, FREEDOMS, and FREEDOMS II trials and their extensions assessed the effects of fingolimod (0.5–1.25 mg/day) on stabilizing or improving disability over ⩽8 years in participants with RMS. CDI and SDI rates were compared between participants initially randomized to fingolimod, interferon (IFNβ-1a), or placebo. Results: At 8 years’ follow-up in TRANSFORMS, 35.1% (95% confidence interval [CI], 28.2%–43.1%) of assessed participants in the IFNβ-1a–fingolimod switch group and 41.9% (36.6%–47.6%) on continuous fingolimod experienced CDI; disability did not worsen in approximately 70%. Similar results were seen in the combined FREEDOMS population. Proportionally fewer TRANSFORMS participants achieved SDI in the IFNβ-1a–fingolimod switch group than on continuous fingolimod (5.4% [3.0%–9.5%] vs 14.2% [10.8%–18.4%], p = 0.01). Conclusion: CDI and SDI are outcomes of interest for clinical trials and for long-term follow-up of participants with RMS. Monitoring CDI and SDI in addition to disability worsening may facilitate understanding of the therapeutic benefit of RMS treatments.

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