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H. Cheng, M. Laron, J. S. Schiffman, R. A. Tang, B. Zhang, V. Rivera, B. Zhang, L. Frishman; Assessing Visual Pathway Function in Multiple Sclerosis (MS) Patients Using Multifocal Visual Evoked Potential (mfVEP) Technique. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3765.
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To evaluate the sensitivity of mfVEP to visual pathway dysfunction in MS patients with and without a history of optic neuritis (ON).
86 eyes of 43 MS patients (diagnosed by the revised McDonald Criteria, age 21-61, mean 39) were divided into 3 groups according to ON history and the time lapse between mfVEP recording and the last ON attack. Group 1 (16 eyes) had the last ON within 6 months, Group 2 (31 eyes) over 6 months, and Group 3 (39 eyes) never had ON. 86 eyes of 43 healthy adults (age 21-57, mean 28) served as a control. Monocular mfVEPs were recorded with a multi-channel technique using 60 sector pattern-reversal dartboard stimuli (VERIS). Data analysis used customized software,1,2 which calculates probability plots for monocular amplitude (MAMP) and latency (MLAT), and interocular amplitude (IAMP) and latency (ILAT). MAMP, IAMP or ILAT were defined as abnormal when 4 or more adjacent points met p<0.05. MLAT was defined as abnormal when 4 or more adjacent points met p<0.01. These cluster criteria had a false positive rate of <5% in control eyes.3 The mfVEP amplitudes (or latencies) for each eye, were defined as abnormal when either the monocular or interocular probability plot was abnormal.
Abnormal mfVEP amplitudes or latencies were detected in 100% of Group 1 eyes, 97% of Group 2 and 33% of Group 3, compared to 10% of control eyes. The percent of eyes having abnormal mfVEP amplitudes was: Group 1) 94%; 2) 74%; 3) 23% and 5% in controls. The percent with abnormal latencies was: Group 1) 91%; 2) 83%; 3) 27% and 6% in controls. For 14 eyes, response amplitudes were too small to measure latencies. Average cluster size (the number of abnormal points within a cluster) for all probability plots was: Group 1) 20; 2) 23; 3) 20; all significantly larger than 6 in controls.
The mfVEP technique is sensitive in detecting visual pathway dysfunction from ON.1. Hood & Greenstein 2003; 2. Fortune et al 2004; 3. Cheng et al 2006
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