Correlation between electrophysiological test and visual dysfunction in multiple sclerosis patients

Abstract

Purpose Evaluate best corrected visual acuity (BCVA), contrast sensitivity (SC), pattern electroretinogram (pERG), multifocal electroretinogram (mfERG), and multifocal visual evoked potentials (mfVEP) in multiple sclerosis (MS) and compare with healthy controls. Methods Fifty‐eight eyes were included: 14 of healthy controls and 44 of subjects with MS (of whom 17 presented a previous episode of optic neuritis). The BCVA ETDRS was recorded at 100% contrast, 2.5% and 1.25%, CS with CSV1000 test (at 3, 6, 9 and 12 cycles per degree) and Pelli Robson. The pERG, mfERG and mfVEP electrophysiology tests were performed with the Roland Consult's Reti‐port / scan device. Results Patients with MS showed a significant reduction of VA at 100% contrast (p = 0.013), 2.5% (p <0.001) and 1.25% (p = 0.008), CSV‐1000 was also affected at 3 (p = 0.017), 9 (p = 0.017), and 12 cycles per degree (p = 0.048), and also Pelli Robson (p <0.001). The mfERG showed in MS patients a significant affectation for amplitude and latency at the inferonasal and superonasal quadrants (p = 0.045 and 0.042 respectively), and the overall values of the mfPEV sown abnormalities at N1 and P1 amplitudes (p = 0.019 and p = 0.039, respectively). Conclusions Patients with MS have a clear impairment of visual function in both psychophysical and electrophysiological tests.

Empirical Mode Decomposition-Based Filter Applied to Multifocal Electroretinograms in Multiple Sclerosis Diagnosis

“…Our findings show that as in previous studies [7,16], the outermost rings (R4 in our case)-as well as the nasal quadrant [18]-and therefore those close to the optic disc, show greater alteration. In the case of [18], significant affectation in mfERG amplitude and latency at the inferonasal (p = 0.045) and superonasal (p = 0.042) quadrants is reported in MS patients with and without prior ON. In our study, the decision to analyze only MS without ON, and therefore in the earliest stage, may be the reason why affectation was not (yet) found in the superonasal quadrant.…”

“…Our hypothesis is that the glutamate imbalance would be transported anterogradely from the brain by the axons, reaching the optic nerve. It would be possible to detect topographical retinal dysfunction in the outer rings and the nasal quadrant in the form of an increase in mfERG amplitude in early-stage MS. With time, in later or more severe stages [7,15,[17][18][19] there would be a decline, as was detected in [17], in which 5 out of 7 patients showed decreased amplitude with predominant macular thinning when examined using optical coherence tomography.…”

“…It should likewise be noted that the studies conducted include patients with different subtypes of the disease and with or without optic neuritis (see Table 3). In MS diagnosis based on the amplitude and latency parameters of first-order kernel waves in previous studies, prolonged latency is the altered parameter found most frequently [7,15,16,18,19], and even Neroev et al [19] suggested using the latency of wave P1 in the parafovea as a marker of MS progression. The studies that detected the classical parameters with greatest alteration (lower amplitudes or higher latencies) in MS patients generally employed a 61-hexagon test [7,16,18,19].…”

“…However, the few papers that have investigated the potential of mfERG analysis for diagnosing MS are based on traditional analysis of amplitudes and latencies and have produced conflicting findings [7,[15][16][17][18][19][20], perhaps because of the heterogeneity of the subjects analyzed (different types of MS and presence/absence of ON) and the use of different mfERG technologies.…”

Diagnosis of multiple sclerosis using multifocal ERG data feature fusion

“…There may be other subsequent waves and even some oscillatory potentials. Outer retinal electroretinographic changes in MS patients have been reported previously [18] , [19] , [20] , [21] , [22] , [23] . In all these papers, amplitude and latency were analysed using traditional methods and the findings varied substantially.…”