Optical coherence tomography and visual evoked potentials: which is more sensitive in MS?

Diagnosis, monitoring and biomarkers:
This study looked at the sensitivity of optical coherence tomography (OCT) and visual evoked potentials (VEPs) in detecting abnormalities of the optic nerves in patients with MS.

Forty MS patients were included in the study, 28 of whom had had optic neuritis in the previous three months. Each patient underwent a range of assessments including visual acuity, EDSS, OCT and VEPs.

Results showed that OCT and VEPs were abnormal in 36% and 56% respectively in all eyes. Individuals with prior optic neuritis had abnormal OCT and VEPs in 68 and 86 per cent respectively, while individuals with no history of optic neuritis had abnormal OCT and VEPs in 19 and 40 per cent respectively.

By combining both OCT and VEP scores, this increased the sensitivity to 89 per cent in optic neuritis and 44 per cent in non-optic neuritis eyes.  A significant correlation was seen between global retinal nerve fibre layer (RNFL) thickness and VEP score and with EDSS. Disease duration correlated with VEP score and RNFL thickness.

From these results we see that OCT was more likely to be abnormal in patients who did not previously have an optic neuritis. The results also show that individuals who previously experienced optic neuritis, both OCT and VEPs showed similar sensitivity. As both these techniques (OCT & VEPs) showed a correlation with disability, they have the potential to be used as a marker of disease burden in MS.

Authors: Di Maggio G, Santangelo R
Source: Mult Scler. 2014 Mar 3. [Epub ahead of print]
Read the abstract


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