Evaluation of pattern-reversal visual evoked potential in patients with neuromyelitis optica

Neto, Silvio Pessanha; Alvarenga, Regina; Vasconcelos, Cláudia Cristina Ferreira; Alvarenga, Marcos Papais; Pinto, Luiz Carlos; Pinto, Verena

doi:10.1177/1352458512447597

Cited by 40 publications

(47 citation statements)

References 24 publications

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“…Among the 38 eyes examined, 18 (47%) had no VEP responses and 13 (34%) had reduced P100 amplitudes with normal latency. From their findings the authors concluded that VEP findings in NMO patients were distinctive, specifically 82% of eyes showed absent responses or decreased amplitudes, as opposed to the pattern typically seen in MS patients characterized by delayed p100 latencies with no change in amplitude in 60-100% of cases [26]. It noteworthy, however, that the aforementioned VEP findings may reflect the severity of the optic nerve injury, and do differentiate the pathobiology of the optic nerve insult in NMO-ON eyes related to MS-ON or sporadic ON eyes.…”

Section: Visual Evoked Potentialsmentioning

confidence: 87%

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Does this optic neuritis patient have neuromyelitis optica? An approach to optic neuritis in the context of neuromyelitis optica

Burton

Costello

2014

Expert Review of Ophthalmology

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Optic neuritis is a common presentation of demyelinating disease, most often associated with multiple sclerosis, and typically associated with a relatively good recovery and prognosis. However, when optic neuritis is the heralding event of neuromyelitis optica (NMO), it is much more likely to be the start of a devastating and disabling chronic disease with a reduced lifespan. Early recognition of NMO is the best chance a patient has of avoiding life-altering disability, as relapse prevention is essentially disability prevention because this disease, unlike MS, does not really have a progressive component. The following review was written to assist the clinician, particularly the ophthalmologist, in assessing optic neuritis in evaluating and recognizing the potential NMO patient. KEYWORDS: aquaporin-4 • demyelinating disease • Devic's disease • immunosuppression • myelopathy • neuromyelitis optica • neuromyelitis optica spectrum disorder • NMO-IgG • optic neuritis • rituximab informahealthcare.com

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Section: Visual Evoked Potentialsmentioning

confidence: 87%

“…VEP testing has been reported to reveal abnormalities in NMO-ON that differ from the classic features of MS-ON. In a recent study by Neto et al, 19 NMO patients underwent pattern reversal VEP testing [26]. Among the 38 eyes examined, 18 (47%) had no VEP responses and 13 (34%) had reduced P100 amplitudes with normal latency.…”

Section: Visual Evoked Potentialsmentioning

confidence: 99%

Does this optic neuritis patient have neuromyelitis optica? An approach to optic neuritis in the context of neuromyelitis optica

Burton

Costello

2014

Expert Review of Ophthalmology

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“…We can conclude that VEP has recently been sufficiently studied and shows differences between the classic pattern of MS and that of NOM, where the responses are more heterogeneous, and the reduction of P100 wave amplitude and the absence of response are more prevalent [34], but data in the literature are lacking about the VEP pattern in RION, CRION, syndromes of the NOM spectrum, and OSMS of MS. …”

Section: Discussionmentioning

confidence: 99%

“…Seven (35%) had amplitudes ≥ 5.8 μV, being considered normal. In 65% of the 20 eyes where the visual response was evocable, a reduction of the P100 wave amplitude was found, with normal latency [34].…”

Section: Vep In Idiopathic Inflammatory Demyelinating Diseasesmentioning

confidence: 99%

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The Visual Evoked Potential in Idiopathic Inflammatory Demyelinating Diseases

Neto¹,

Pinto²,

Papais-Alvarenga³

2017

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Within the group of inflammatory idiopathic demyelinating diseases, there is a great number of diseases that have an initial attack in common, including visual. Multiple sclerosis (MS) is a chronic, demyelinating, immune-mediated disease, with considerably varying prevalence and incidence. Neuromyelitis optica (NMO), which until recently was considered a variant of MS, is currently considered an independent entity. However, it resembles MS, because it is an immune-mediated disease characterized by the simultaneous or sequential involvement in time of optic neuritis and extensive demyelinating myelitis. Fifty percent of patients with MS have isolated optic neuritis. However, the frequency of abnormalities ranges from 57 to 100% in visual evoked potential (VEP). Several studies have evaluated the clinical, evolutive, and demographic characteristics of idiopathic optic neuritis and demonstrated their differences among the cases related to MS and NMO. The most common changes in VEP studies in multiple sclerosis are as follows: increased interocular differential latency of P100 wave and the absolute increase in latency of P100 wave. New studies indicate that VEP pattern in NOM spectrum syndromes is different from that of MS.

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Update on the diagnosis and treatment of neuromyelitis optica: Recommendations of the Neuromyelitis Optica Study Group (NEMOS)

et al. 2013

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Neuromyelitis optica (NMO, Devic’s syndrome), long considered a clinical variant of multiple sclerosis, is now regarded as a distinct disease entity. Major progress has been made in the diagnosis and treatment of NMO since aquaporin-4 antibodies (AQP4-Ab; also termed NMO-IgG) were first described in 2004. In this review, the Neuromyelitis Optica Study Group (NEMOS) summarizes recently obtained knowledge on NMO and highlights new developments in its diagnosis and treatment, based on current guidelines, the published literature and expert discussion at regular NEMOS meetings. Testing of AQP4-Ab is essential and is the most important test in the diagnostic work-up of suspected NMO, and helps to distinguish NMO from other autoimmune diseases. Furthermore, AQP4-Ab testing has expanded our knowledge of the clinical presentation of NMO spectrum disorders (NMOSD). In addition, imaging techniques, particularly magnetic resonance imaging of the brain and spinal cord, are obligatory in the diagnostic workup. It is important to note that brain lesions in NMO and NMOSD are not uncommon, do not rule out the diagnosis, and show characteristic patterns. Other imaging modalities such as optical coherence tomography are proposed as useful tools in the assessment of retinal damage. Therapy of NMO should be initiated early. Azathioprine and rituximab are suggested as first-line treatments, the latter being increasingly regarded as an established therapy with long-term efficacy and an acceptable safety profile in NMO patients. Other immunosuppressive drugs, such as methotrexate, mycophenolate mofetil and mitoxantrone, are recommended as second-line treatments. Promising new therapies are emerging in the form of anti-IL6 receptor, anti-complement or anti-AQP4-Ab biologicals.

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Evaluation of pattern-reversal visual evoked potential in patients with neuromyelitis optica

Abstract: Evaluation of VEP in patients with definite NMO revealed a pattern that is different from that of MS in 81.6% of eyes examined, characterized by the absence of responses, or decreased amplitude with normal latency.

Cited by 40 publications

References 24 publications

Does this optic neuritis patient have neuromyelitis optica? An approach to optic neuritis in the context of neuromyelitis optica

Does this optic neuritis patient have neuromyelitis optica? An approach to optic neuritis in the context of neuromyelitis optica

The Visual Evoked Potential in Idiopathic Inflammatory Demyelinating Diseases

Update on the diagnosis and treatment of neuromyelitis optica: Recommendations of the Neuromyelitis Optica Study Group (NEMOS)

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