Diagnostic ability of multifocal electroretinogram in early multiple sclerosis using a new signal analysis method

Area of Science:

• Ophthalmology
• Neurology
• Medical Imaging

Background:

• Multiple sclerosis (MS) diagnosis can be challenging in early stages, particularly without optic neuritis (ON).
• Multifocal electroretinogram (mfERG) is a tool used to assess retinal function.
• Standard mfERG analysis may have limitations in detecting subtle changes indicative of early MS.

Purpose of the Study:

• To evaluate a novel analysis method for mfERG signals.
• To determine if this new method enhances diagnostic value for early-stage MS.
• To assess the efficacy in patients without a history of ON.

Main Methods:

• mfERG signals from 15 early-stage MS patients (no prior ON) and 6 controls were analyzed.
• Amplitude and latency of N1 and P1 waves were measured.
• A normalized root-mean-square error (FNRMSE) method was employed for signal analysis, with area under the ROC curve (AUC) as the discriminant factor.

Main Results:

• Standard analysis of N1 wave amplitudes in ring R3 achieved an AUC of 0.82.
• The FNRMSE method demonstrated superior discrimination across all retinal analysis regions compared to the standard method.
• The highest AUC of 0.91 was achieved in the superior temporal quadrant using the FNRMSE method.

Conclusions:

• The novel FNRMSE analysis of mfERG recordings can effectively detect early-stage MS.
• This method provides enhanced diagnostic value, especially in patients lacking a history of ON.
• mfERG analysis, particularly with advanced methods, is a valuable tool for early MS detection.