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Analysis of multiple sclerosis patients with electrophysiological and structural tests

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Abstract

We aimed to analyze the effects of progressive myelin loss and neurodegeneration seen in patients with multiple sclerosis (MS) on visual tract with electrophysiological and structural tests. Fifty-one patients diagnosed with MS in the Neurology Department were followed up in neuro-ophthalmology outpatient clinic irrespective of their visual symptoms, and were included in our study. The patients were classified as the ones with the history of optic neuritis (group II) and ones without the history (group I) of optic neuritis. The data, including clinical presentation, retinal nerve fiber layer thickness (RNFLT) measurements, pattern visual evoked potential (pVEP) and flash electro retino grams (ERG) test results, were recorded. In our study, comparison of pVEP test latencies of groups I and II with each other, and with those of healthy subjects revealed statistically significant differences (p < 0.05). The analysis of rod functions on ERG did not show any significant changes (p > 0.05). However, both groups showed significantly decreased cone b-wave amplitudes, elongation of latencies, and decreased flicker amplitudes on cone and flicker potentials obtained after light adaptation (p < 0.05). There was significant thinning in RNFLT of the both groups when compared to the normal standards. The difference between two groups was statistically significant (p < 0.05). Axon loss is seen in the optic nerve with subclinical or acute optic neuritis in patients with MS. RNFLT analysis and electrophysiological tests are of great importance in diagnosis of MS, as well as to determine progression and to direct neuroprotective therapy in patients diagnosed with MS. Objective analysis methods gain more importance in the diagnosis and follow-up of MS patients, parallel to technological advancements.

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References

  1. Polman CH, Reingold SC, Edan G et al (2005) Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald Criteria”. Ann Neurol 58:840–846

    Article  PubMed  Google Scholar 

  2. Hamurcu MŞ, Orhan G, Kalaycı D, Sarıcaoglu MS, Çöllüoglu Z, Hasıripi H (2007) The evaluation of the visual System in multiple sclerosis patients. MN Ophthalmol 14:163–165

    Google Scholar 

  3. Walsh TJ (1992) Neuro-ophthalmology: clinical signs and symptoms, 3rd edn. Lea and Febiger, Philadelphia, pp 430–431

    Google Scholar 

  4. Trip SA, Schlottmann PG, Jones SJ, Altmann DR, Garway-Heath DF, Thompson AJ (2005) Retinal nerve fiber layer axonal loss and visual dysfunction in optic neuritis. Ann Neurol 58:383–391

    Article  PubMed  Google Scholar 

  5. Kerrison JB, Flynn T, Green WR (1994) Retinal pathologic changes in multiple sclerosis. Retina 14:445–451

    Article  CAS  PubMed  Google Scholar 

  6. Gordon-Lipkin E, Chodkowski B, Reich DS, Smith SA, Pulicken M, Balcer LJ, Frohman EM, Cutter G, Calabresi PA (2007) Retinal nerve fiber layer is associated with brain atrophy in multiple sclerosis. Neurology 69:1603–1609

    Article  CAS  PubMed  Google Scholar 

  7. Cheng H, Laron M, Schiffman JS, Tang RA, Frishman LJ (2007) The relationship between visual field and retinal nerve fiber layer measurements in patients with multiple sclerosis. Investig Ophthalmol Vis Sci 48:5798–5805

    Article  Google Scholar 

  8. Sriram P, Wang C, Yiannikas C, Garrick R, Barnett M, Parratt J, Graham SL, Arvind H, Klistorner A (2014) Relationship between optical coherence tomography and electrophysiology of the visual pathway in non-optic neuritis eyes of multiple sclerosis patients. PLoS One 9(8):e102546. doi:10.1371/journal.pone.0102546

    Article  PubMed  PubMed Central  Google Scholar 

  9. Hamurcu M, Sarıcaoglu MS, Kara S, Karakurt A (2014) Pattern electroretinogram and optical coherence tomography in patients with ocular hypertension. Glo-Kat 4:249–252

    Google Scholar 

  10. Khanifar AA, Parlitsis GJ, Ehrlich JR, Aaker GD, D’Amico DJ, Gauthier SA, Kiss S (2010) Retinal nerve fiber layer evaluation in multiple sclerosis with spectral domain optical coherence tomography. Clin Ophthalmol 4:1007–1013

    PubMed  PubMed Central  Google Scholar 

  11. Tsuda H, Ishikawa H, Matsunaga H, Mizutani T (2004) A neuro-ophthalmological analysis in 80 cases of multiple sclerosis. Rinsho Shinkeigaku 44(8):513–521

    PubMed  Google Scholar 

  12. Da Pozzo S, Iacono P, Marchesan R, Minutola D, Ravalico G (2006) The effect of ageing on retinal nerve fibre layer thickness: an evaluation by scanning laser polarimetry with variable corneal compensation. Acta Ophthalmol Scand 84:375–379

    Article  PubMed  Google Scholar 

  13. Herrero R, Garcia-Martin E, Almarcegui C, Ara JR, Rodriguez-Mena D, Martin J, Otin S, Satue M, Pablo LE, Fernandez FJ (2012) Progressive Degeneration of the retinal nerve fiber layer in patients with multiple sclerosis. Investig Ophthalmol Vis Sci 53:13

    Google Scholar 

  14. Parisi V, Manni G, Spadaro M, Colacino G, Restuccia R, Marchi S, Bucci MG, Pierelli F (1999) Correlation between morphological and functional. Retinal ımpairment in multiple sclerosis patients. Investig Ophthalmol Vis Sci 40:2520–2527

    CAS  Google Scholar 

  15. Costello F, Hodge W, Pan YI, Burton JM, Freedman MS, Stys PK, Trufyn J, Kardon R (2012) Sex-specific differences in retinal nerve fiber layer thinning after acute optic neuritis. Neurology 79(18):1866–1872

    Article  PubMed  PubMed Central  Google Scholar 

  16. Gundogan FC, Demirkaya S, Sobaci G (2007) Is optical cherence tomography really a new biomarker candidate in multiple sclerosis. A structural and functional evaluation. Investig Ophthalmol Vis Sci 48:5773–5781

    Article  Google Scholar 

  17. Visual Electrodiagnostics (2009 update) A guide to procedures: standards, recommendations and guidelines ISCEV Publications. England 1–13

  18. Papakostopoulos D, Fotiou F, Hart JC, Banerji NK (1989) The electroretinogram in multiple sclerosis and demyelinating optic neuritis. Electroencephalogr Clin Neurophysiol 74:1–10

    Article  CAS  PubMed  Google Scholar 

  19. Holder GE (1997) The pattern electroretinogram in anterior visual pathway dysfunction and its relationship to the pattern visual evoked potentials: a personal critical review of 743 eyes. Eye 11:924–934

    Article  PubMed  Google Scholar 

  20. Taş A, Gundogan FC, Akgün H, Erdem Ü, Sobaci G (2013) Spatial tuning function of pattern visual evoked potentials in multiple sclerosis patients without optic neuritis history. Medicinski glasnik 10(1):99–105

    PubMed  Google Scholar 

  21. Halliday AM, McDonald WI, Mushin J (1973) Visual evoked response in diagnosis of multiple sclerosis. Br Med J 4:661–664

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Frohman EM, Frohman TC, Zee DS, McColl R, Galetta S (2005) The neuro-ophthalmology of multiple sclerosis. Lancet Neurol 4:111–121

    Article  PubMed  Google Scholar 

  23. Gundogan FÇ, Tas A, Altun S, Oz O, Erdem Ü, Sobaci G (2013) Color vision versus pattern visual evoked potentials in the assessment of subclinical optic pathway involvement in multiple sclerosis. Indian J Ophthalmol 61(3):100–103

    Article  PubMed  PubMed Central  Google Scholar 

  24. Kupersmith MJ, Nelson JI, Seiple WH, Carr RE, Weiss PA (1983) The 20/20 eye in multiple sclerosis. Neurology 33:1015–1020

    Article  CAS  PubMed  Google Scholar 

  25. Pierelli F, Pozzessere G, Stefano E, Martelli M, Rizzo PA, Morocutti C (1985) Pattern visual evoked potentials and flash electroretinogram in clinically definite multiple sclerosis. Eur Neurol 24(5):324–329

    Article  CAS  PubMed  Google Scholar 

  26. Sisto D, Trojano M, Vetrugno M, Trabucco T, Iliceto G, Sborgia C (2005) Subclinical visual involvement in multiple sclerosis: a study by MRI, VEPs, frequency-doubling perimetry, standard perimetry, and contrast sensitivity. Investig Ophtalmol Vis Sci 4:1264–1268

    Article  Google Scholar 

  27. Green IJ, McQuaid S, Hauser SL, Allen IV, Lyness R (2010) Ocular pathology in multiple sclerosis: retinal atrophy and inflammation irrespective of disease duration. Brain 133:1591–1601

    Article  PubMed  PubMed Central  Google Scholar 

  28. Calabresi PA, Balcer LJ, Frohman EM (2010) Retinal pathology in multiple sclerosis: insight into the mechanisms of neuronal pathology. Brain 133(Pt 6):1575–1577

    Article  PubMed  PubMed Central  Google Scholar 

  29. Halilovic EA, Alimanovic I, Suljic E, Hassan NA (2014) Optic neuritis as first clinical manifestations the multiple sclerosis. Mater Sociomed 26(4):246–248

    PubMed  PubMed Central  Google Scholar 

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None of the authors have financial or proprietary interests in any material or methods mentioned.

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Correspondence to Mualla Hamurcu.

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Hamurcu, M., Orhan, G., Sarıcaoğlu, M.S. et al. Analysis of multiple sclerosis patients with electrophysiological and structural tests. Int Ophthalmol 37, 649–653 (2017). https://doi.org/10.1007/s10792-016-0324-2

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  • DOI: https://doi.org/10.1007/s10792-016-0324-2

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