Abstract Details

Title Optical Coherence Tomography and Visual Evoked Potentials: Which Is More Sensitive in Multiple Sclerosis?

Topic Clinical Neurophysiology

Presentation(s) P07 - (-)

Poster/Presentation
Number 181

Objective

Background BACKGROUND: The existing literature comparing the diagnostic utility of OCT and VEPs in detecting visual pathway involvement is lacking.

Design/Methods DESIGN/METHODS: Fourty patients with MS, of whom 23 with unilateral or bilateral (n=5) optic neuritis (ON) at least 3 months before underwent assessment of visual acuity (VA), Expanded Disability Status Scale (EDSS), OCT and VEPs, the latter quantified according to a 4-graded conventional score.

Results RESULTS: In eyes with previous ON, OCT sensitivity was 68% for global RNFL thickness (64%for temporal quadrant) vs 71% for VEP Only 61% eyes were abnormal at both examinations. Abnormal VEPs only were found in 11% and OCT only in 7%, while the combination of the two detected abnormalities in 79% of eyes. In eyes without previous ON OCT sensitivity was 19% for global RNFL thickness, (17%for temporal quadrant) vs 31% for VEP. Only 15% eyes were abnormal at both examinations. Abnormal VEPs only were found in 15% and OCT only in 4%, while the combination of the two detected abnormalities in 35% of eyes. No significant difference was found between OCT and VEP sensitivity (McNemar Test p<0.05). In eyes without previous ON, DD was significantly correlated with temporal RNFL quadrant thickness (Pearson's r=-0.3, p=0.02). VEP score and RNFL thickness were significantly correlated with EDSS (global RNFL: Spearman rs=-0.43, p=0.001; temporal RNFL: rs=-0.33, p=0.01; VEP score: rs=0.45, p=0.0002) and with VA (global RNFL: rs=0.30, p=0.03; temporal RNFL: rs=0.42, p=0.002; VEP score: rs=-0.43, p=0.001).

Conclusions CONCLUSIONS: The combination of OCT and VEP increases the overall sensitivity compared to the single examination. Moreover the stronger correlation in non-ON eyes between RNFL thickness and overall disability underlines the role of OCT as an indirect assessment tool of brain atrophy.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
Michael Levy, MD, PhD, FAAN (Massachusetts General Hospital/Harvard Medical School)	Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mitsubishi Pharma. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB Pharma. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Levy has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various law firms. The institution of Dr. Levy has received research support from National Institutes Health.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Lucia Moiola, MD, PhD (Fondazione Centro San Raffaele)	Dr. Moiola has nothing to disclose.
	No disclosure on file
Vittorio Martinelli (S. Raffaele Hospital)	Dr. Martinelli has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis, Biogen, Sanofi Genzyme, TEVA and Merck. Dr. Martinelli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck .
Giancarlo Comi, MD (University Vita-Salute)	Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Janssen. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Aspen Healthcare. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Sanofi. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Rewind.
	No disclosure on file

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