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Updated: Dec 27, 2025
Dynamic Visual Tests to Identify and Quantify Visual Damage and Repair Following Demyelination in Optic Neuritis Patients
Published on: April 14, 2014
Optimization of spectral domain optical coherence tomography and visual evoked potentials to identify unilateral
Raed Behbehani1, Abdullah Ali1, Hamd Al-Omairah1
1Al-Bahar Ophthalmology Center, Ibn Sina Hospital, P.O Box 1180, Kuwait.
Background:
Optic neuritis is a common manifestation of multiple sclerosis and frequently the presenting sign. The diagnosis of MS is heavily based on MRI findings but the latter is relatively insensitive in detecting optic nerve lesions. Identification of optic nerve lesion using ancillary tools such spectral-domain optical coherence tomography (SDOCT) by measuring the retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL), and visual-evoked potentials latencies (VEP) may facilitate early diagnosis and treatment of multiple sclerosis.
Objective:
To determine the optimal of SDOCT measures in RFNL and GCIPL and the VEP latency value for the identification of a prior symptomatic optic nerve lesion.
Methods:
Thirty patients with diagnosed clinically with optic neuritis and fifty healthy control subjects were tested with SDOCT and VEP and the sensitivity, specificity, negative and positive predictive values of optimal values from healthy controls and optic neuritis patients were determined of for the identification unilateral optic nerve lesion.
Results:
The inter-eye GCIPL difference of 3.5 µm is highly sensitive (100%) and specific (98%) in identifying unilateral optic nerve lesion, while lowest 5th percentile normal GCIPL threshold values of 71 µm was highly sensitive (100%) but less specific (83.3%). The inter-eye RNFL difference of 5.5 µm had a sensitivity of 70% and specificity of 90% in identifying optic nerve lesion while the lower 5th percentile normal RNFL value of 92.3 µm was poorly sensitive (40%). Finally, the 95th percentile normal VEP latency of 104.50 milliseconds had sensitivity of 80% and specificity of 76% in identifying optic nerve lesion.
Conclusions:
The inter-eye GCIPL difference is a powerful index for identifying unilateral optic nerve lesion, while the inter-eye RNFL difference and 95th percentile normal VEP latency had very good sensitivity and specificity. These measures can be useful in the evaluation of the first demyelinating event of MS and therefor can facilitate early diagnosis and therapy.
