Evaluation of optic neuropathy in multiple sclerosis using low-contrast visual evoked potentials

M J Thurtell; E Bala; S S Yaniglos; J C Rucker; N S Peachey; R J Leigh

doi:10.1212/WNL.0b013e3181c3fd43

Back

Evaluation of optic neuropathy in multiple sclerosis using low-contrast visual evoked potentials

Journal article

Open access

Peer reviewed

Evaluation of optic neuropathy in multiple sclerosis using low-contrast visual evoked potentials

M J Thurtell, E Bala, S S Yaniglos, J C Rucker, N S Peachey and R J Leigh

Neurology, Vol.73(22), pp.1849-1857

12/01/2009

DOI: 10.1212/WNL.0b013e3181c3fd43

PMCID: PMC2788801

PMID: 19949031

Files and links (1)

url

https://doi.org/10.1212/WNL.0b013e3181c3fd43View

Published (Version of record) Open Access

Abstract

Contrast acuity (identification of low-contrast letters on a white background) is frequently reduced in patients with demyelinating optic neuropathy associated with multiple sclerosis (MS), even when high-contrast (Snellen) visual acuity is normal. Since visual evoked potentials (VEPs) induced with high-contrast pattern-reversal stimuli are typically increased in latency in demyelinating optic neuropathy, we asked if VEPs induced with low-contrast stimuli would be more prolonged and thus helpful in identifying demyelinating optic neuropathy in MS. We studied 15 patients with clinically definite MS and 15 age-matched normal controls. All subjects underwent a neuro-ophthalmologic assessment, including measurement of high-contrast visual acuity and low-contrast acuities with 25%, 10%, 5%, 2.5%, and 1.25% contrast Sloan charts. In patients with MS, peripapillary retinal nerve fiber layer (RNFL) thickness was determined using optical coherence tomography. Monocular VEPs were induced using pattern-reversal checkerboard stimuli with 100% and 10% contrast between checks, at 5 spatial frequencies (8-130 minutes of arc). VEP latencies were significantly increased in response to low- compared with high-contrast stimuli in both groups. VEP latencies were significantly greater in patients with MS than controls for both high- and low-contrast stimuli. VEP latencies correlated with high- and low-contrast visual acuities and RNFL thickness. VEPs were less likely to be induced with low- than with high-contrast stimuli in eyes with severe residual visual loss. Visual evoked potentials obtained in patients with multiple sclerosis using low-contrast stimuli are increased in latency or absent when compared with those obtained using high-contrast stimuli and, thus, may prove to be helpful in identifying demyelinating optic neuropathy.

Contrast Sensitivity - physiology

Humans

Middle Aged

Optic Nerve Diseases - diagnosis

Male

Statistics as Topic

Reaction Time - physiology

Tomography, Optical Coherence - methods

Electroencephalography - methods

Case-Control Studies

Multiple Sclerosis - complications

Evoked Potentials, Visual - physiology

Photic Stimulation - methods

Adult

Female

Aged

Optic Nerve Diseases - etiology

Visual Acuity - physiology

Details

Title: Subtitle: Evaluation of optic neuropathy in multiple sclerosis using low-contrast visual evoked potentials
Creators: M J Thurtell - Departments of Neurology, University Hospitals Case Medical Center, Cleveland, USA. mj.thurtell@gmail.com
E Bala
S S Yaniglos
J C Rucker
N S Peachey
R J Leigh
Resource Type: Journal article
Publication Details: Neurology, Vol.73(22), pp.1849-1857
Publisher: United States
DOI: 10.1212/WNL.0b013e3181c3fd43
PMID: 19949031
PMCID: PMC2788801
ISSN: 1526-632X
eISSN: 1526-632X
Grant note: R01 EY12830 / NEI NIH HHS R01 EY16501 / NEI NIH HHS R01 EY06717 / NEI NIH HHS R01 EY006717-24 / NEI NIH HHS EY06717 / NEI NIH HHS R01 EY006717 / NEI NIH HHS
Language: English
Date published: 12/01/2009
Academic Unit: Neurology; Ophthalmology and Visual Sciences
Record Identifier: 9983980082302771

Metrics

13 Record Views

27 Times Cited - Web of Science