Foveal versus peripheral retinal responses: a new analysis for early diagnosis of multiple sclerosis

Visual potentials evoked by brief flashes (VEPs) were recorded in 85 patients with MS, 30 healthy controls and 25 neurological patients without demyelinating diseases. In a group of 44 patients, diffuse field stimulation was used, resutling in 15 altered responses (34%). In a second group of 41 patients with superimposable characteristics including age, sex, diagnosis of MS (definite, probable and possible) and score on the Rose's scale, the separate responses of central and peripheral retina were analysed. A total of 30 abnormal VEPs were recognized (73%) with the following distribution: 16 foveal VEPs (78%), 4 peripheral responses (13%) and 26 centreperiphery latency differences (CPLD, 60%). Twenty subjects of Group A with normal or slightly altered full field VEPs were retested with both stimulating methods with the following result: 3 altered full field VEPs (15%) and 15 abnormal CPLD (75%). With diffuse field stimulation, the correlation between the VEP scores and the results of other examinations (visual, pyramidal, etc.) were insignficant; on the contrary, the CPLD was clearly correlated with the involvement of the visual and other systems in the fluctuating clinical course of MS.