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M. Laron, H. Cheng, J. S. Schiffman, R. A. Tang, B. Zhang, V. Rivera, L. J. Frishman; Structural and Functional Assessment of the Visual Pathway in Multiple Sclerosis (MS) Patients Using Optical Coherence Tomography (OCT) and Multifocal Visual Evoked Potential (mfVEP). Invest. Ophthalmol. Vis. Sci. 2007;48(13):3761.
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To assess agreement between functional (mfVEP) and structural (OCT) tests in MS patients with or without a history of optic neuritis (ON).
MfVEP and OCT3 (RNFL) were performed on 35 MS patients diagnosed by the revised McDonald Criteria. Group 1 (29 eyes) had the last ON attack over 6 months before testing, and Group 2 (35 eyes) never had ON. Monocular mfVEPs were obtained from both eyes of each subject using a pattern reversal dartboard stimulus (VERIS) and analyzed with customized software.1 The mfVEP was considered abnormal if the interocular or monocular amplitude probability plot had 2 or more adjacent points with reduced amplitude P<1%, or 4 or more adjacent points with P<5%. The OCT was considered abnormal if the average RNFL was reduced P<5%. For topographic comparisons, OCT measures were divided into 4 quadrants (temporal, superior, inferior and nasal) and compared to corresponding field locations for mfVEPs.1,2 For each quadrant, the mfVEP was considered abnormal if monocular or interocular amplitude probability plots met the cluster criteria given above. For OCT, each quadrant was considered abnormal if 1 of the 3 sectors within that quadrant had significantly reduced RNFL <1% or two sectors <5%.
The two tests agreed for 79% of eyes and 72% of quadrants for Group 1 and 69% of eyes and 80% of quadrants for Group 2. OCT and mfVEP together detected abnormality in 83% of eyes and 60% of quadrants for Group 1; and 37% of eyes and 21% of quadrants for Group 2. OCT was abnormal in 72% of eyes and 50% quadrants for Group 1; and 11% of the eyes and 10% quadrants for Group 2. Abnormal mfVEPs were found in 72% of eyes and 43% quadrants in Group 1, and 31% of eyes and 11% of quadrants in Group 2.
The mfVEP and OCT tests showed ~75% agreement. Both tests are valuable for the visual pathway assessment in MS patients.1. Hood & Greenstein 2003; 2. Garway-Heath et al 2002
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