[Early diagnosis of optic nerve neuropathy in multiple sclerosis]

To evaluate diagnostic sensitivity of clinical tests in optic demyelinating neuropathy.

We examined 21 persons (38 eyes) with confirmed sclerosis multiplex (SM) with no episodes of posterior optic neuritis in the history of the disease. The examination method included: Static perimetry of central visual field (30 degrees, by Octopus 101), pattern visual evoked potentials (p VEP), colour photographs of optic disc and magnetic resonance imaging (MR) of central nervous system, optic nerves and optic chiasm. Visual acuity and colour vision were normal.

There was statistically significant elongation in the latency of P 100 in pattern VEP (> 118 ms, 3 x SD), and significant reduction in mean light sensitivity (MS) in central visual field. MRI revealed demyelinisation in cortex and/or spinal cord of all patients and demyelinating lesion in optic nerve of one patient. There was no Gd-DTPA enhancement. In statistical analysis there was no correlation between results of pattern VEP, IMR, morphology of optic disc, and duration of SM, stage of the disease (in Kurtzke gradation scale) or age of patient. In regression analysis there were statistically significant relationships (p < 0.05) between results of central static perimetry, duration and stage of disease.