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A. Klistorner, S. Graham, C. Fraser, R. Garrick, T. Nguyen, M. Paine, J. O'Day, H. Arvind, J. Grigg, F. Billson; Electrophysiological Evidence for Heterogeneity of Lesions in Optic Neuritis. Invest. Ophthalmol. Vis. Sci. 2007;48(13):916.
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© ARVO (1962-2015); The Authors (2016-present)
To examine the natural history of electrophysiological changes after first episode of optic neuritis (ON) in patients with magnetic resonance imaging (MRI) changes consistent with demyelination
20 patients with a first episode of ON and MRI lesions consistent with demyelination were examined using multi-focal visual evoked potentials. Changes in amplitude and latency of mfVEP were analised at 1, 3, 6 and 12 months after an acute attack.
Out of 20 patients, at the end of the 12-month period, 5 showed persistent loss of amplitude, most marked centrally. The remaining 15 patients recovered amplitude by 1 month, but all had delayed latency, also most marked centrally. Of these, two distinct sub-groups were identified: 5 with no improvement in latency and 10 demonstrating marked and steady latency recovery over 12 months suggesting remyelination. In the follow up period conversion to MS was most likely in the group with severe amplitude loss (5 out of 5) followed by patients with no latency recovery (3 out of 5). The conversion rate was least in the group of patients who demonstrated latency improvement (3 out of 10).
Distinct patterns of disease evolution were identified using mfVEP in patients with optic neuritis and high risk of MS development. This supports the concept of histopathological heterogeneity of early lesions in MS.
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