The value of tests evaluating visual functions in detecting overt or subclinical optic neuritis in multiple sclerosis

Öcek, Özge; Gedizlioğlu, Muhteşem; Köşkderelioğlu, Aslı; Ortan, Pınar; Yüksel, Bora; Türe, Melih; Gediz, Feyza

doi:10.1016/j.msard.2018.01.030

Cited by 4 publications

(4 citation statements)

References 26 publications

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“…This could be explained by the fact that patients younger at onset have demonstrated to experience larger number of relapses before progression, in accordance with literature (49). A positive correlation was demonstrated between foveal sensitivity threshold and VA at baseline (rho = 0.79, p < 0.0001), and it appears as interesting information since there are described cases with FT decline and relatively good visual acuity in the context of subclinical optic neuritis or cases with good FT measurements but very reduced vision as per involvement of factors other than optic neuropathy (50). Linear regression analysis showed that baseline foveal sensitivity threshold was the only variable significantly correlated with final visual acuity, with a statistically significant positive association (B = 1.39; CI (95%) = 0.93-1.85; p < 0.0001).…”

Section: Discussionsupporting

confidence: 86%

High-dose vitamin B supplementation for persistent visual deficit in multiple sclerosis: a pilot study

Mallone

Lucchino

Franzone

et al. 2020

DD&T

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B Vitamins group, visual function, neuroprotection The aim of this study is to investigate the potential neuroprotective effect of high-doses vitamins B1, B6 and B12 in patients with relapsing-remitting multiple sclerosis (RRMS) and persistent visual loss after acute optic neuritis (AON). Sixteen patients (20 eyes) diagnosed with RRMS and visual permanent disability following AON were enrolled for the present open, pilot study. Each patient was treated with oral high-doses 300 mg of vitamin B1, 450 mg of vitamin B6 and 1,500 mcg of vitamin B12, as add-on treatment to concomitant disease-modifying therapies (DMTs) for consecutive 90 days. Outcome measures were to determine changes from baseline to month three in visual acuity (VA) and visual field (VF) testing, with correlations with clinical parameters. Logistical regression was performed to evaluate predictors of final VA. A statistically significant improvement was registered in visual acuity (p = 0.002) and foveal sensitivity threshold (FT) (p = 0.006) at follow-up compared to baseline. A similar trend was demonstrated for mean deviation (MD) (p < 0.0001), and pattern standard deviation (PSD) (p < 0.0001). Age at the time of inclusion was positively correlated with latency time (rho = 0.47, p = 0.03), while showing a negative correlation with visual acuity (rho =-0.45, p = 0.04) and foveal sensitivity threshold (rho =-0.6, p = 0.005) at follow up. A statistically significant correlation was demonstrated between foveal sensitivity threshold and visual acuity at baseline (rho = 0.79, p < 0.0001). In a linear regression model, the main predictor of visual acuity at follow up was the foveal sensitivity threshold (B = 1.39; p < 0.0001). Supplemental high-dose vitamins B1, B6 and B12 resulted as effective therapy to improve visual function parameters in MS-related visual persistent disability.

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Section: Discussionsupporting

confidence: 86%

High-dose vitamin B supplementation for persistent visual deficit in multiple sclerosis: a pilot study

Mallone

Lucchino

Franzone

et al. 2020

DD&T

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“…In conclusion, our study suggests that LC-VA can better detect the visual disturbance in ON than HC-VA in NMOSD as well as MS (8,11,14,(19)(20)(21)27). Considering all of those, 2.5% LC-VA might be the most useful, feasible, and rapid method to detect evidence of ON and could be used as a potential additive diagnostic tool of ON.…”

Section: Discussionmentioning

confidence: 72%

“…Even though HC-VA has demonstrated normal results, patients with ON often complain of "discomfort" in their vision (13). HC-VA often did not differentiate slight changes in visual function by ON and cannot detect subtle visual disturbance or recovery over time (8,19).…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies investigated LC-VA and identified it to be a highly reliable visual assessment method in MS patients with and without ON (20). Additionally, the clinical relationship between ON or worsening LC-VA has been demonstrated (14,19,21), which suggests its role as an early indicator of ON associated with the visual disturbance (21). However, there have been limitations such as the lack of comparative studies in a large number of patients and being studied only in MS patients (19,21).…”

Section: Discussionmentioning

confidence: 99%

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Low Contrast Visual Acuity Might Help to Detect Previous Optic Neuritis

Park

Shin

et al. 2020

Front. Neurol.

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Optic neuritis (ON) has been considered to be an important factor in the diagnosis of multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD), making ON detection increasingly critical for early diagnosis. Furthermore, subclinical ONs presenting no distinct decrease in visual acuity can be missed. Low contrast visual acuity (LC-VA) is known to be able to capture visual loss not seen in conventional high-contrast visual acuity (HC-VA) in MS. Therefore, to increase the sensitivity of ON detection, we investigated the advantage of LC-VA over conventional HC-VA. One hundred and eight patients with demyelinating disease (35 MS, 73 NMOSD) with ON at least 3 months prior and 35 controls underwent neuro-ophthalmic evaluation, including best-corrected conventional high contrast visual acuity (HC-VA) and 2.5% and 1.25% low contrast visual acuity (LC-VA). Receiver operating characteristic (ROC) curve analysis and the area under the curve (AUC) of various visual functions were used to determine the most relevant visual function test for the detection of optic nerve involvement. Additionally, the optimal cutoff point was obtained from the Youden index (J-index) as the points with the best sensitivity-specificity balance. When distinguishing ON from non-ON, the area under the ROC curve (AUC) was highest for the 2.5% LC-VA (0.835, P < 0.001; sensitivity 71.5%, specificity 88.6%), while it was 0.710 (P < 0.001) for the HC-VA and 0.770 (P < 0.001) for the 1.25% LC-VA. In discriminating between controls and ON, the AUC was also highest for the 2.5% LC-VA 0.754 (P < 0.001; sensitivity 71.5%, specificity 78.5%), while it was 0.719 (P < 0.001) for HC-VA and 0.688 (P < 0.001) for 1.25% LC-VA. In eyes with a history of ON (n = 137), the HC-VA and 2.5% LC-VA were abnormal in 64.2 and 71.5%, respectively (P < 0.001), with their combination detecting abnormalities in approximately 85.4% (P < 0.001). The 2.5% LC-VA was superior to HC-VA in detecting ON when distinguishing ON from non-ON or control. The 2.5% LC-VA might be a useful, feasible, and rapid method to detect ON. Furthermore, combining 2.5% LC-VA with conventional HC-VA would be better for detecting optic nerve involvements.

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Sensitivity and specificity of visual evoked potentials for early diagnosis of demyelinating diseases

Abildúa¹,

Menargues²,

Lucas³

et al. 2022

Neurology Perspectives

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The value of tests evaluating visual functions in detecting overt or subclinical optic neuritis in multiple sclerosis

Cited by 4 publications

References 26 publications

High-dose vitamin B supplementation for persistent visual deficit in multiple sclerosis: a pilot study

High-dose vitamin B supplementation for persistent visual deficit in multiple sclerosis: a pilot study

Low Contrast Visual Acuity Might Help to Detect Previous Optic Neuritis

Sensitivity and specificity of visual evoked potentials for early diagnosis of demyelinating diseases

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