Visual system as a predictor of change from CIS to MS

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Visual system as a predictor of change from CIS to MS

Postby MSUK » Wed Sep 10, 2014 12:49 am

Evaluation of visual structural and functional factors that predict the development of multiple sclerosis in clinically isolated syndrome patients.

Perez-Rico C, Ayuso-Peralta L, Rubio-Pérez L, Roldán-Díaz I, Arévalo-Serrano J, Jiménez Jurado D, Blanco R.

Abstract

PURPOSE. To evaluate visual pathway structure and function in patients with clinical isolated syndrome (CIS) using spectral domain optical coherence tomography (OCT) and multifocal visual evoked potentials (mfVEP), predicting CIS conversion to clinically definite multiple sclerosis (MS).

METHODS. This observational, longitudinal study assessed the eyes with no prior history of optic neuritis of twenty-nine consecutive patients with CIS according to the McDonald criteria. The relationships of the mfVEP results with the clinical findings, psychophysical (Humphrey perimetry) and structural (OCT) diagnostic test data were investigated.

RESULTS. The mfVEP amplitude responses (interocular and monocular probability analysis) showed abnormal cluster visual field defects in 48.3% of the CIS eyes, while mfVEP latency analysis showed significant delays in 20.7%. OCT average RNFLT (retinal nerve fiber layer thickness) was significantly reduced compared to the control group (P = 0.02). Significant differences between CIS eyes with abnormal and normal mfVEP latencies were found for the OCT RNFLT (P < 0.001) with a longer latency being linked to more severe axonal damage. Using multivariate logistic regression analysis, OCT average RNFLT was found to be independent predictor of clinically definitive MS diagnosis at twelve months.

CONCLUSIONS. The combined use of OCT and mfVEP is helpful to detect significant subclinical visual pathways abnormalities and axonal loss in CIS patients. Retinal axonal loss measured by OCT is an important prognosis factor of conversion to MS in patients with clinically isolated syndrome in absence of symptomatic optic neuritis.

Source: Invest Ophthalmol Vis Sci. 2014 Sep 4. pii: IOVS-14-14807. doi: 10.1167/iovs.14-14807 © 2014 by Association for Research in Vision and Ophthalmology & Pubmed PMID: 25190654 (10/09/14) http://www.ms-uk.org/msetiology
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