Sensitivity of optical coherence tomography and visual evoked potential in demyelinating optic neuritis

Abstract

Aim The aim of this study is to analyze the structural and functional abnormalities of the optic nerve in multiple sclerosis (MS) patients utilizing optical coherence tomography (OCT) and visual evoked potential (VEP). We compare between eyes with and without a history of neuritis. Patients and methods A cross-sectional study which compared 60 eyes of MS patients with 20 eyes of the healthy control group. MS patients were classified into MS with optic neuritis (MS-ON, n=44) and MS without optic neuritis (MS-NON, n=16). Both VEP and OCT were done. Results Both groups showed thinning in the retinal nerve fiber layer (RNFL), ganglion cell complex, and prolongation in latency (P100). The decrement in RNFL was more in the MS-ON group in superior RNFL, temporal RNFL, and average RNFL (P=0.002, 0.002, 0.03), respectively. In the MS-ON group, the average, temporal, and nasal RNFL showed significant negative correlation with latency of P100 (P=0.0001, 0.0001, 0.001), respectively. Latency of P100 showed higher sensitivity (52.3%) over temporal RNFL (43.2%) in detecting ON. Conclusion Both VEP and OCT have been proven to be sensitive tools in the detection of optic neuropathy in MS. Latency showed the highest sensitivity followed by the temporal RNFL. Temporal RNFL and average ganglion cell complex can be a biomarker for both axonal and neuronal loss in eyes with and without neuritis. This loss can precede the demyelination process.