Fraser Clare L, Klistorner Alexander, Graham Stuart L, Garrick Raymond, Billson Francis A, Grigg John R
Department of Electrophysiology, Save Sight Institute, University of Sydney, Sydney, NSW, Australia.
Ophthalmology. 2006 Feb;113(2):323.e1-323.e2. doi: 10.1016/j.ophtha.2005.10.017. Epub 2006 Jan 10.
To determine the sensitivity of multifocal visual evoked potentials (mVEP) in optic neuritis of an inflammatory or demyelinating nature.
Cross-sectional study.
Sixty-four patients participated who had a confirmed diagnosis of optic neuritis (ON) (past and acute). Based on the McDonald multiple sclerosis (MS) criteria, 25 patients (27 eyes with ON) were deemed to have isolated optic neuritis and thus not have MS (i.e., the not-MS group), and 19 patients (24 eyes with ON) had a diagnosis of MS (i.e., the MS group). The remaining 20 patients (25 eyes with ON) were at a high risk of MS, but diagnostic evaluation was equivocal, and thus were classified as the possible MS group. A control group of 20 normal patients was enrolled.
The mVEP test was performed using the Accumap. All ON patients had recent magnetic resonance imaging scans of the brain and spinal cord.
Multifocal visual evoked potentials amplitude and latency values were analyzed within each group and were compared with the normal controls.
No abnormality was recorded on mVEP in the control group. Of all the ON eyes, 74 (97.3%) were abnormal on mVEP testing. Amplitude values were abnormal in 92.6% of not-MS eyes, 92.0% of possible MS eyes, and 100% of those with MS, and latency was abnormal in 33.3%, 76.0%, and 100%, respectively. There was a significant difference in the mVEP latency z-scores among all ON groups (P<0.01; Kruskal-Wallis test). Although distribution graphs of latency z-scores in the not-MS and MS groups had single peaks and were clearly separate from each other, the latency z-score distribution within the possible MS group in postacute patients was bimodal, with each peak corresponding to the distribution of the not-MS and MS group, respectively. The mVEP latency z-scores had a sensitivity and specificity of 100% in detecting patients with ON due to MS when compared with normal patients.
The mVEP test is a sensitive and specific tool for detecting optic neuritis. There was a significant difference in latency analysis findings between patient groups as classified according to the McDonald MS criteria. Latency results suggest a role in identifying a patient's risk for future MS.
确定多焦视觉诱发电位（mVEP）在炎症性或脱髓鞘性视神经炎中的敏感性。
横断面研究。
64例确诊为视神经炎（ON）（既往和急性）的患者参与研究。根据麦克唐纳多发性硬化症（MS）标准，25例患者（27只患ON的眼睛）被认为患有孤立性视神经炎，因此没有MS（即非MS组），19例患者（24只患ON的眼睛）被诊断为MS（即MS组）。其余20例患者（25只患ON的眼睛）有很高的MS风险，但诊断评估不明确，因此被归类为可能的MS组。招募了20例正常患者作为对照组。
使用Accumap进行mVEP测试。所有ON患者近期均进行了脑和脊髓的磁共振成像扫描。
分析每组内的多焦视觉诱发电位振幅和潜伏期值，并与正常对照组进行比较。
对照组mVEP未记录到异常。在所有患ON的眼睛中，74只（97.3%）在mVEP测试中异常。非MS组眼睛的振幅值异常率为92.6%，可能的MS组为92.0%，MS组为100%，潜伏期异常率分别为33.3%、76.0%和100%。所有ON组之间的mVEP潜伏期z评分存在显著差异（P<0.01；Kruskal-Wallis检验）。虽然非MS组和MS组的潜伏期z评分分布图有单峰且彼此明显分开，但急性后期可能的MS组内的潜伏期z评分分布是双峰的，每个峰分别对应非MS组和MS组的分布。与正常患者相比，mVEP潜伏期z评分在检测因MS导致的ON患者时敏感性和特异性均为100%。
mVEP测试是检测视神经炎的一种敏感且特异的工具。根据麦克唐纳MS标准分类的患者组之间，潜伏期分析结果存在显著差异。潜伏期结果提示其在识别患者未来发生MS的风险方面有作用。
