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Dynamic Visual Tests to Identify and Quantify Visual Damage and Repair Following Demyelination in Optic Neuritis Patients

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Multifocal visual evoked potentials in optic neuritis and multiple sclerosis: A review.

Gorm Pihl-Jensen¹, Mathias Falck Schmidt¹, Jette Lautrup Frederiksen¹

¹Clinic of Optic Neuritis and Clinic of Multiple Sclerosis, Department of Neurology, Rigshospitalet - Glostrup, University of Copenhagen, Nordre Ringvej 57, 2600 Glostrup, Denmark.

Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology

|May 23, 2017

Summary

Multifocal visual evoked potential (mf-VEP) offers superior diagnostic and prognostic value for optic neuritis and multiple sclerosis compared to traditional methods. This advanced technique precisely maps visual field lesions, aiding in understanding disease progression and recovery.

Keywords:

Clinical neurophysiology Multifocal visual evoked potentials Multiple sclerosis Optic neuritis

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Area of Science:

Ophthalmology and Neuroscience
Neuro-immunology
Clinical Electrophysiology

Background:

Optic neuritis (ON) and multiple sclerosis (MS) are neurological conditions affecting the optic nerve.
Classical full-field visual evoked potential (ff-VEP) has limitations in precisely localizing visual pathway damage.
Multifocal visual evoked potential (mf-VEP) offers a novel approach to assess visual field function with higher topographical resolution.

Purpose of the Study:

To conduct a literature review on the application of mf-VEP in diagnosing and monitoring ON and MS.
To evaluate the diagnostic and prognostic utility of mf-VEP in comparison to established clinical and imaging techniques.
To explore the potential of mf-VEP in understanding the pathophysiology of MS, including demyelination, atrophy, and remyelination.

Main Methods:

Comprehensive literature search of studies utilizing mf-VEP in ON and MS.
Analysis of mf-VEP performance against optical coherence tomography (OCT), ff-VEP, MRI, standard automated perimetry, and visual acuity tests.
Review of studies investigating mf-VEP for lesion detection, functional recovery tracking, and prediction of MS risk.

Main Results:

Mf-VEP demonstrated good correlation with OCT, ff-VEP, MRI, and visual acuity measures.
Mf-VEP exhibited superior sensitivity and specificity over ff-VEP in detecting ON and MS-related lesions, particularly small or peripheral ones.
Abnormal mf-VEP in the unaffected eye of ON patients may predict MS risk, and the technique shows promise in tracking functional recovery.

Conclusions:

Mf-VEP is a valuable diagnostic and prognostic tool for ON and MS, providing detailed topographical visual field information.
Mf-VEP aids in correlating structural damage with functional deficits, offering insights into MS pathophysiology.
Despite a lack of standardization across mf-VEP systems, the technique shows significant promise for clinical application in neuro-ophthalmology.