Multifocal visual evoked potential evaluation for diagnosis of acute optic neuritis and for prediction of visual outcome and ganglion cell layer thinning following optic neuritis

Background:: While damage to the optic nerve following optic neuritis (ON) is readily quantifiable, the evaluation of prognosis for visual function and neuroaxonal loss in the acute ON is challenging. Objective:: The objective of this study is to investigate the value of multifocal visual evoked potential (mfVEP) in acute ON, diagnostically for acute ON and prognostically for visual outcome and subsequent ganglion cell/inner plexiform layer thickness (GCLIPLt). Methods:: A prospective cohort study of mfVEP and full-field visual evoked potential (ffVEP) in acute, unilateral ON (onset < 31 days) was conducted. Comparisons with healthy controls ( n = 30) and association analysis with follow-up optical coherence tomography (OCT) measurements (of the GCLIPLt) and visual function (Sloan low-contrast visual acuity (LCVA)) were conducted. Results:: Seventy-nine ON patients were included (mean: 17 days from onset). Excluding measurements with conduction block, ffVEP ( n = 54) and mfVEP ( n = 44) showed sensitivities of 89% and 84% to a specificity of 97%. 65/79 patients were re-examined (mean: 200 days follow-up). mfVEP amplitude and latency inter-eye asymmetry in acute ON correlated with GCLIPLt ( r = 0.587 and Spearman’s ρ = 0.597, for both, p < 0.001). mfVEP amplitude correlated with LCVA inter-eye asymmetry at follow-up ( r = 0.421, p < 0.001), mfVEP latency did not. Conclusion: mfVEP may support the prognostic evaluation of acute ON patients and prove valuable in future neuroprotective and remyelinating trials. In acute ON, the increase in diagnostic value of mfVEP to ffVEP may be limited due to widespread conduction block.

Clinical Features and Visual outcome in Acute and Recurrent Case of Optic Neuritis.

Nepal Medical Journal ◽

10.37080/nmj.19 ◽

2018 ◽

Vol 1 (01) ◽

pp. 56-63

Author(s):

Jyoti Bastola Paudel ◽

Ananda Kumar Sharma ◽

Sanjeeta Sitaula ◽

Madhu Thapa

Keyword(s):

Multiple Sclerosis ◽

Natural History ◽

Optic Neuritis ◽

Clinical Features ◽

Visual Evoked Potential ◽

Evoked Potential ◽

Oral Steroid ◽

Visual Recovery ◽

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.

Assessment of Opicinumab in Acute Optic Neuritis Using Multifocal Visual Evoked Potential

CNS Drugs ◽

10.1007/s40263-018-0575-8 ◽

2018 ◽

Vol 32 (12) ◽

pp. 1159-1171 ◽

Cited By ~ 16

Author(s):

Alexander Klistorner ◽

◽

Yi Chai ◽

Letizia Leocani ◽

Philipp Albrecht ◽

...

Keyword(s):

Optic Neuritis ◽

Visual Evoked Potential ◽

Evoked Potential ◽

Acute Optic Neuritis ◽

Prediction of higher visual function in macular degeneration with multifocal electroretinogram and multifocal visual evoked potential

Ophthalmic and Physiological Optics ◽

10.1111/opo.12152 ◽

2014 ◽

Vol 34 (5) ◽

pp. 540-551 ◽

Cited By ~ 1

Author(s):

Anne Herbik ◽

Franziska Geringswald ◽

Hagen Thieme ◽

Stefan Pollmann ◽

Michael B. Hoffmann

Keyword(s):

Macular Degeneration ◽

Visual Function ◽

Visual Evoked Potential ◽

Evoked Potential ◽

Multifocal Electroretinogram ◽

The contribution of multifocal visual evoked potentials in patients with optic neuritis and multiple sclerosis: a review

Documenta Ophthalmologica ◽

10.1007/s10633-020-09799-4 ◽

2020 ◽

Author(s):

Paraskevas Zafeiropoulos ◽

Andreas Katsanos ◽

George Kitsos ◽

Maria Stefaniotou ◽

Ioannis Asproudis

Keyword(s):

Multiple Sclerosis ◽

Optic Neuritis ◽

Visual Evoked Potential ◽

Evoked Potential ◽

Automated Perimetry ◽

Standard Automated Perimetry ◽

Published Evidence ◽

Multifocal Vep ◽

Abstract Purpose To review the evidence on the usefulness of the multifocal visual evoked potential (mfVEP) test in patients with optic neuritis (ON) and/or multiple sclerosis (MS). Methods We critically review key published evidence on the use of mfVEP in ON/MS patients and its association with other functional and structural tests. Results Multifocal VEP tests are useful in detecting abnormality in patients with ON/MS and monitor the progression of lesions (remyelination, atrophy). In addition, mfVEP has good correlation with conventional visual evoked potential (VEP), standard automated perimetry, optical coherence tomography and magnetic resonance imaging. In patients with ON, mfVEP might be useful in predicting the risk of conversion to MS.

Multifocal Visual Evoked Potential Analysis of Inflammatory or Demyelinating Optic Neuritis

Ophthalmology ◽

10.1016/j.ophtha.2005.10.017 ◽

2006 ◽

Vol 113 (2) ◽

pp. 315-323.e2 ◽

Cited By ~ 33

Author(s):

C FRASER ◽

A KLISTORNER ◽

S GRAHAM ◽

R GARRICK ◽

F BILLSON ◽

...

Keyword(s):

Optic Neuritis ◽

Visual Evoked Potential ◽

Evoked Potential ◽

Potential Analysis ◽

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

Evolution of Visual Evoked Potentials in Optic Neuritis

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 ◽

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.