Color vision versus pattern visual evoked potentials in the assessment of subclinical optic pathway involvement in multiple sclerosis

Abstract

Background:Optic pathway involvement in multiple sclerosis is frequently the initial sign in the disease process. In most clinical applications, pattern visual evoked potential (PVEP) is used in the assessment of optic pathway involvement.Objective:To question the value of PVEP against color vision assessment in the diagnosis of subclinical optic pathway involvement.Materials and Methods:This prospective, cross-sectional study included 20 multiple sclerosis patients without a history of optic neuritis, and 20 healthy control subjects. Farnsworth-Munsell (FM) 100-Hue testing and PVEPs to 60-min arc and 15-min arc checks by using Roland-Consult RetiScan® system were performed. P100 amplitude, P100 latency in PVEP and total error scores (TES) in FM 100-Hue test were assessed.Results:Expanded Disability Status Scale score and the time from diagnosis were 2.21 ± 2.53 (ranging from 0 to 7) and 4.1 ± 4.4 years. MS group showed significantly delayed P100 latency for both checks (P < 0.001). Similarly, MS patients had significantly increased total error scores (TES) in FM-100 Hue (P < 0.001). The correlations between TESs and PVEP amplitudes / latencies were insignificant for both checks (P > 0.05 for all). 14 MS patients (70%) had an increased TESs in FM-100 Hue, 11 (55%) MS patients had delayed P100 latency and 9 (45%) had reduced P100 amplitude. The areas under the ROC curves were 0.944 for FM-100 Hue test, 0.753 for P100 latency, and 0.173 for P100 amplitude.Conclusions:Color vision testing seems to be more sensitive than PVEP in detecting subclinical visual pathway involvement in MS.

Relationship between Visual Dysfunction and Retinal Changes in Patients with Multiple Sclerosis

“…In a recent study, the Farnsworth D-100 color test (based on the same principle as the Farnsworth and L´Anthony D15 color tests) was demonstrated to be more sensitive than pattern visual evoked potentials in detecting subclinical visual pathway alterations in MS patients making this color test a valuable tool for evaluating these patients. [ 35 ]…”

Microvascular blood flow velocities measured with a retinal function imager: inter-eye correlations in healthy controls and an exploration in multiple sclerosis

“…The lack of difference in BFVs between MSON and MSNON eyes could relate to bias in an excess of more subclinical optic neuropathy in the MSNON cohort included in this study. Optic neuropathy in MS may be overt (as in clinical optic neuritis) or occult (as in subclinical optic neuropathy), with optic nerve affliction being virtually ubiquitous as part of the MS disease process [ 34 , 35 ]. Nevertheless, this raises the possibility that microcirculation aberrations may be more widespread in MS than previously thought.…”

Selective Colour Vision Deficits in Multiple Sclerosis at Different Temporal Stages

“…Recently, it has been shown that the optic nerve and retina are affected in MS patients without any clinical evidence or history of ON. [2][3][4] Given that there is no myelin and oligodendrocytes in the retina, retinal damage has been hypothesized to be secondary to retrograde trans-synaptic neurodegeneration as a result of damage to optic nerve and chiasmatic/postchiasmatic visual pathways. Alternatively, retinal and optic nerve damage without a history of ON may indicate a primary ocular neurodegenerative process that represents the extent of cortical neurodegeneration in MS.…”

“…On the other hand, performing the FM 100 hue test is time consuming and not practical in a clinic environment. [2][3][4]20 The Farnsworth D-15 panel is another colour vision test that was developed as a colour vision grading test for use in vocational guidance. 21,22 This test is not able to detect minor abnormalities in colour vision.…”