Optical coherence tomography and visual evoked potentials: which is more sensitive in multiple sclerosis?

Area of Science:

• Neuro-ophthalmology
• Neuroscience
• Medical Imaging

Background:

• Multiple sclerosis (MS) is a demyelinating disease affecting the central nervous system.
• Visual pathway involvement is common in MS, leading to optic neuritis (ON) and visual impairment.
• Optic coherence tomography (OCT) and visual evoked potentials (VEPs) are electrophysiological and imaging techniques used to assess visual pathway integrity.

Purpose of the Study:

• To evaluate the diagnostic sensitivity of OCT and VEPs in detecting visual pathway abnormalities in MS patients.
• To compare the effectiveness of OCT and VEPs in eyes with and without a history of ON.
• To explore the correlation between OCT and VEP findings and clinical disability measures in MS.

Main Methods:

• A cohort of 40 MS patients was recruited.
• Participants underwent visual acuity testing, Expanded Disability Status Scale (EDSS) assessment, OCT, and VEPs.
• VEPs were quantified using a conventional 0-4 score.

Main Results:

• OCT and VEPs showed abnormalities in 36% and 56% of all eyes, respectively.
• Sensitivity increased to 68% (OCT) and 86% (VEPs) in eyes with prior ON, and 19% (OCT) vs. 40% (VEPs) in eyes without ON history.
• Combining OCT and VEPs yielded 89% sensitivity in ON eyes and 44% in non-ON eyes. Both measures correlated significantly with EDSS and disease duration.

Conclusions:

• VEPs demonstrated higher sensitivity than OCT in MS eyes without a history of ON.
• OCT and VEPs exhibited comparable sensitivity in eyes with a history of ON.
• The strong correlation of OCT and VEP measures with disability suggests their potential as biomarkers for MS disease burden.