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Liu J, Jin M, Zhang M, Wang Y, Sun S. Multimodal evoked potentials are useful for the diagnosis of pediatric acute disseminated encephalomyelitis. BMC Pediatr 2024; 24:92. [PMID: 38308211 PMCID: PMC10835841 DOI: 10.1186/s12887-024-04576-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 01/18/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND The application of evoked potentials (EPs) to the diagnosis of acute disseminated encephalomyelitis (ADEM ) has not been investigated in detail. The aim of this study, therefore, was to analyze the value of multimodal EPs in the early diagnosis of pediatric ADEM. METHODS This was a retrospective study in which we enrolled pediatric ADEM patients and controls (Cs) from neurology units between 2017 and 2021. We measured indices in patients using brainstem auditory evoked potentials (BAEPs), visual evoked potentials (VEPs) and somatosensory evoked potentials (SEPs), and then we analyzed their early diagnostic value in ADEM patients. RESULTS The mean age of the ADEM group was 6.15 ± 3.28 years (range,1-12 years) and the male/female ratio was 2.1:1 The mean age of the Cs was 5.97 ± 3.40 years (range,1-12 years) and the male/female ratio was 1.3:1. As we used magnetic resonance imaging (MRI) as the diagnostic criterion, the sensitivity, specificity, and accuracy (κ was 0.88) of multimodal EPs were highly consistent with those of MRI; and the validity could be ranked in the following order with respect to the diagnosis of ADEM: multimodal Eps > single SEP > single VEP > single BAEP. Of 34 patients with ADEM, abnormalities in multimodal EPs were 94.12%, while abnormalities in single VEPs, BAEPs and SEPs were 70.59%,64.71%and 85.3%, respectively. We noted significant differences between single VEP/BAEPs and multimodal EPs (χ2 = 6.476/8.995,P = 0.011/0.003). CONCLUSIONS The combined application of multimodal EPs was superior to BAEPs, VEPs, or SEPs alone in detecting the existence of central nerve demyelination, and we hypothesize that these modalities will be applicable in the early diagnosis of ADEM.
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Affiliation(s)
- Jing Liu
- The Children Hospital of Hebei Province, Shijiazhuang, Hebei, 050000, China
| | - Mei Jin
- The Children Hospital of Hebei Province, Shijiazhuang, Hebei, 050000, China.
- The Key Laboratory of Pediatric Epilepsy and Neurological Disorders of Hebei Province, Shijiazhuang, Hebei, 050000, China.
| | - Meijie Zhang
- The Children Hospital of Hebei Province, Shijiazhuang, Hebei, 050000, China
- The Key Laboratory of Pediatric Epilepsy and Neurological Disorders of Hebei Province, Shijiazhuang, Hebei, 050000, China
| | - Yonggang Wang
- The Children Hospital of Hebei Province, Shijiazhuang, Hebei, 050000, China
| | - Suzhen Sun
- The Children Hospital of Hebei Province, Shijiazhuang, Hebei, 050000, China.
- The Key Laboratory of Pediatric Epilepsy and Neurological Disorders of Hebei Province, Shijiazhuang, Hebei, 050000, China.
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Donica VC, Alexa AI, Pavel IA, Danielescu C, Ciapă MA, Donica AL, Bogdănici CM. The Evolvement of OCT and OCT-A in Identifying Multiple Sclerosis Biomarkers. Biomedicines 2023; 11:3031. [PMID: 38002031 PMCID: PMC10669604 DOI: 10.3390/biomedicines11113031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/09/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
The prevalence of multiple sclerosis (MS) has been increasing among young people in developing countries over the last years. With the continuous development of new technology, the diagnosis and follow-up of these patients has received new parameters that physicians may use in their practice. This paper reviews the main biomarkers identified through Optical Coherence Tomography Angiography (OCT-A) involved in the development and progression of MS and investigates the role it may have in detecting changes to the central nervous system (CNS).
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Affiliation(s)
- Vlad Constantin Donica
- Department of Ophthalmology, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No. 16, 700115 Iasi, Romania; (V.C.D.); (C.D.); (C.M.B.)
| | - Anisia Iuliana Alexa
- Department of Ophthalmology, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No. 16, 700115 Iasi, Romania; (V.C.D.); (C.D.); (C.M.B.)
| | - Irina Andreea Pavel
- Department of Ophthalmology, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No. 16, 700115 Iasi, Romania; (V.C.D.); (C.D.); (C.M.B.)
| | - Ciprian Danielescu
- Department of Ophthalmology, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No. 16, 700115 Iasi, Romania; (V.C.D.); (C.D.); (C.M.B.)
| | | | | | - Camelia Margareta Bogdănici
- Department of Ophthalmology, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No. 16, 700115 Iasi, Romania; (V.C.D.); (C.D.); (C.M.B.)
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Zhang M, Ji M, Tan M, Yu Y, Guan H. Evaluation of Fundus Function in Mature Cataract Patients by Visual Electrophysiology. J Ophthalmol 2023; 2023:9065094. [PMID: 37942179 PMCID: PMC10630009 DOI: 10.1155/2023/9065094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 09/18/2023] [Accepted: 10/05/2023] [Indexed: 11/10/2023] Open
Abstract
Purpose To explore the value of visual electrophysiology in evaluating the fundus function of mature cataract patients. Methods 124 mature cataract patients (153 eyes) were examined before cataract surgery; the examinations included best corrected visual acuity (BCVA), pattern visual evoked potential (PVEP), full-field electroretinogram (ffERG), and multifocal electroretinogram (mfERG). According to the postoperative fundus conditions, the subjects were divided into two groups: the no fundus disease group and the fundus disease group. Approximately one month after the operation, BCVA was measured, and visual electrophysiology was performed on subjects who had a stable fundus condition and had not received treatment for fundus disease. Results One month after cataract surgery, BCVA ≤ 0.3 logMAR was found in 60 eyes (96.8%) without fundus disease and 59 eyes (64.8%) with fundus disease. Compared with the group without fundus disease, the preoperative electrophysiological examination of the group with fundus disease showed that the amplitude of ffERG waves and the amplitude density of the P1 wave in the 2nd to 5th rings of mfERG were decreased (all P < 0.05). ffERG and mfERG can be used for differential diagnosis of fundus disease (all P < 0.05), while PVEP has no significant diagnostic value for fundus disease (all P > 0.05). In the group without fundus disease, the amplitude of the PVEP 15' P100 wave and the amplitude of dark-adapted (DA) 0.01 b-wave, DA 3.0 a-wave, and DA 10.0 a-wave were negatively correlated with postoperative logMAR BCVA (all P < 0.05). In the group with fundus disease, the amplitude of PVEP and ffERG and the amplitude density of mfERG were negatively correlated with postoperative logMAR BCVA (all P < 0.05). In the eyes of cortical cataracts, some parameters of PVEP, ffERG, and mfERG were significantly different before and after surgery. In the eyes of nuclear cataracts, some parameters of ffERG and mfERG were significantly different before and after surgery. In the eyes of posterior subcapsular cataracts, some parameters of PVEP and ffERG were significantly different before and after surgery. Conclusions ffERG and mfERG can be used to detect fundus disease in mature cataract patients. The preoperative visual electrophysiological examination has high clinical value in predicting postoperative vision of mature cataract patients with fundus disease. Different types of cataracts have different effects on electrophysiological examination results. When interpreting the electrophysiological report, it is necessary to consider the existence of cataracts. This trial is registered with 2019-K068.
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Affiliation(s)
- Min Zhang
- Eye Institute, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong 226001, Jiangsu, China
| | - Min Ji
- Eye Institute, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong 226001, Jiangsu, China
| | - Mengjia Tan
- Eye Institute, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong 226001, Jiangsu, China
| | - Ying Yu
- Eye Institute, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong 226001, Jiangsu, China
| | - Huaijin Guan
- Eye Institute, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong 226001, Jiangsu, China
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Moussa H, Sawaya RA, Deeb R, El Ayoubi N. Correlation of Pattern Reversal and Flash Visual Evoked Potential Latencies With Optical Coherence Tomography Measures in Patients With Optic Neuropathy and Patients With Multiple Sclerosis Without Optic Neuropathy. J Clin Neurophysiol 2022; 39:637-642. [PMID: 33555731 DOI: 10.1097/wnp.0000000000000827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The object of the study is to relate the pattern reversal visual evoked potential (PRVEP) and flash VEP (f-VEP) latencies with retinal neurons and their fibers. METHODS We studied 104 eyes. Forty-two eyes from patients with optic neuritis (ON), 28 eyes from patients with multiple sclerosis without involvement of the optic nerves (MS-non-ON), and 34 eyes of normal controls. RESULTS Pattern reversal visual evoked potential latency is more delayed in patients with ON than in patients with multiple sclerosis nonON. Flash visual evoked potential (f-VEP) latency was delayed in both categories. Peripapillary retinal nerve fiber layer (pRNFL) and ganglion cell/inner plexiform layer (GCIPL) thickness was lower in patients with ON and multiple sclerosis non-ON. In patients with ON, f-VEP latencies correlated negatively with pRNFL thickness but not GCIPL thickness. In patients with ON, PRVEP latencies did not correlate with pRNFL thickness but correlate negatively with GCIPL thickness. CONCLUSIONS Patients with ON have delayed VEPs and thinner optical coherence tomography values. Flash visual evoked potentials correlate with pRNFL, indicating axonal pathology. PRVEP correlate with GCIPL, indicating ganglion cell pathology. Abnormal PRVEP with preserved normal f-VEP indicate isolated myelin damage. Abnormalities in both PRVEP and f-VEP indicate myelin and axonal damage in the optic nerve. Combining the results of PRVEP, f-VEP, pRNFL, and GCIPL, one can define the location, type, and extent of the lesion in the macula and optic nerve.
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Affiliation(s)
- Hussein Moussa
- Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon
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Covey TJ, Golan D, Doniger GM, Sergott R, Zarif M, Bumstead B, Buhse M, Kaczmarek O, Mebrahtu S, Bergmann C, Wilken J, Gudesblatt M. Longitudinal assessment of the relationship between visual evoked potentials and cognitive performance in multiple sclerosis. Clin Neurophysiol 2022; 137:66-74. [DOI: 10.1016/j.clinph.2022.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 01/24/2022] [Accepted: 02/15/2022] [Indexed: 11/03/2022]
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Pinheiro HM, da Costa RM. Pupillary light reflex as a diagnostic aid from computational viewpoint: A systematic literature review. J Biomed Inform 2021; 117:103757. [PMID: 33826949 DOI: 10.1016/j.jbi.2021.103757] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 03/12/2021] [Accepted: 03/13/2021] [Indexed: 01/06/2023]
Abstract
This work presents a detailed and complete review of publications on pupillary light reflex (PLR) used to aid diagnoses. These are computational techniques used in the evaluation of pupillometry, as well as their application in computer-aided diagnoses (CAD) of pathologies or physiological conditions that can be studied by observing the movements of miosis and mydriasis of the human pupil. A careful survey was carried out of all studies published over the last 10 years which investigated, electronic devices, recording protocols, image treatment, computational algorithms and the pathologies related to PLR. We present the frontier of existing knowledge regarding methods and techniques used in this field of knowledge, which has been expanding due to the possibility of performing diagnoses with high precision, at a low cost and with a non-invasive method.
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Phase-synchrony evaluation of EEG signals for Multiple Sclerosis diagnosis based on bivariate empirical mode decomposition during a visual task. Comput Biol Med 2019; 117:103596. [PMID: 32072973 DOI: 10.1016/j.compbiomed.2019.103596] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 12/29/2019] [Accepted: 12/29/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVE Despite the widespread prevalence of Multiple Sclerosis (MS), the study of brain interactions is still poorly understood. Moreover, there has always been a great need to automate the MS diagnosis procedure to eliminate the evaluation errors thereby improving its consistency and reliability. To address these issues, in this work, we proposed a robust pattern recognition algorithm as a computer-aided diagnosis system. This method is based on calculating the pairwise phase-synchrony of EEG recordings during a visual task. Initially, the bivariate empirical mode decomposition (BEMD) was applied to extract the intrinsic mode functions (IMFs). The phases of these IMFs were then obtained using the Hilbert transform to be utilized in the mean phase coherence (MPC), a measure for phase-synchrony calculation. After the construction of the feature space using MPC values, the ReliefF algorithm was applied for dimension reduction. Finally, the best distinguishing features were input to a k-nearest neighbor (KNN) classifier. The results revealed a higher level of network synchronization in the posterior regions of the brain and desynchronization in the anterior regions among the MS group as compared with the normal subjects. In the validation phase, the leave-one-subject-out cross-validation (LOOCV) method was used to assess the validity of the proposed algorithm. We achieved an accuracy, sensitivity, and specificity of 93.09%, 91.07%, and 95.24% for red-green, 90.44%, 88.39%, and 92.62% for luminance, and 87.44%, 87.05%, and 87.86% for blue-yellow tasks, respectively. The experimental results demonstrated the reliability of the presented method to be generalized in the field of automated MS diagnosis systems.
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Functional Evaluation of the Visual Pathway in Patients with Multiple Sclerosis Using a Multifunction Stimulator Monitor. J Ophthalmol 2019; 2019:2890193. [PMID: 31641531 PMCID: PMC6769350 DOI: 10.1155/2019/2890193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 07/30/2019] [Indexed: 12/04/2022] Open
Abstract
Objectives To assess the capability of the vision monitor unit Monpack One of detecting visual function alterations in patients with multiple sclerosis (MS) and to evaluate the correlation between structural retinal parameters and functional measurements obtained with this device. Methods Forty-eight patients with MS and 46 healthy controls were included in a cross-sectional study. All participants underwent a complete functional evaluation of the visual pathway, which included low-contrast visual acuity (LCVA), contrast sensitivity vision (CSV), automated perimetry, multifocal visual evoked potentials (mfVEPs), and pattern electroretinogram (ERG). All tests were performed using the vision monitor unit Monpack One (Metrovision, France), a multifunction stimulator device. Retinal structural measurements were obtained in all subjects using Triton swept source optical coherence tomography (Topcon, Japan). Results Patients with MS presented reduced low-contrast VA (p < 0.001) and reduced CSV at medium (p=0.001, p=0.013) and low (p=0.001, p=0.002) spatial frequencies. All visual field parameters were found to be altered in MS patients compared with controls (≤0.001). Patients with MS presented lower amplitude of the P100 waveform of the mfVEP in areas corresponding to central (p < 0.001), inferonasal (p=0.001), and inferotemporal (p=0.003) retina. The pattern ERG did not show significant differences. Significant correlations were observed between structural retinal measurements and functional parameters, especially between the inner macular areas and measurements corresponding to contrast sensitivity and perimetry indexes. Conclusions Patients with MS present visual dysfunction detectable with the vision monitor unit Monpack One. This device may be a fast and useful tool to provide a full evaluation of axonal damage in patients with multiple sclerosis.
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Lambe J, Saidha S, Bermel RA. Optical coherence tomography and multiple sclerosis: Update on clinical application and role in clinical trials. Mult Scler 2019; 26:624-639. [PMID: 32412377 DOI: 10.1177/1352458519872751] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Optical coherence tomography (OCT) has emerged as a fast, non-invasive, inexpensive, high-resolution imaging technique in multiple sclerosis (MS). Retinal layer quantification by OCT facilitates a 'window' into not only local retinal pathology but also global neurodegenerative processes, recognised to be the principal substrates of disability accumulation in MS. While OCT measures in MS have been demonstrated to reflect visual function, inflammatory activity outside of the visual pathways, disability measures including the prediction of disability progression, whole brain atrophy, and the differential neuroprotective effects of disease-modifying therapies, debate continues regarding the clinical utility of OCT in everyday practice. This review presents an overview of the evidence supporting OCT, with particular focus on its application in the MS clinic. We will also discuss the role of OCT in MS clinical trials to develop novel neuroprotective and potential remyelinating therapies.
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Affiliation(s)
- Jeffrey Lambe
- Department of Neurology, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Shiv Saidha
- Department of Neurology, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Robert A Bermel
- Mellen Center for Multiple Sclerosis, Cleveland Clinic, Cleveland, Ohio, USA
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Lotfy NM, Alasbali T, Khandekar R. Macular ganglion cell complex parameters by optical coherence tomography in cases of multiple sclerosis without optic neuritis compared to healthy eyes. Indian J Ophthalmol 2019; 67:648-653. [PMID: 31007230 PMCID: PMC6498937 DOI: 10.4103/ijo.ijo_1378_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Purpose: To compare different macular thickness parameters and peripapillary retinal nerve fiber layer (RNFL) thickness between recently diagnosed cases of multiple sclerosis (MS) without optic neuropathy (ON) and healthy individuals. Methods: This cross-sectional study was performed between June 2014 and June 2015. All subjects underwent ocular and retinal examination. Spectral domain optical coherence tomography (SD-OCT) was used to measure the thickness of different layers of the retina at macular and peripapillary regions and at different quadrants. Between groups comparison was performed with P < 0.05 indicating statistical significance. Results: There were 32 eyes in the MS group and 74 eyes in the control group. The MS group was significantly younger than the control group (P < 0.001). The mean ganglion cell complex (GCL++) thickness in superior macular area was 64.1 ± 8.9 μ in the MS group and 71.1 ± 5.9 μ in the control group. The thickness of the RNFL did not statistically differ in each of the quadrants between groups. Despite controlling for age, the macular thickness parameters were significantly thinner in eyes with MS compared to healthy eyes (P < 0.01). Conclusion: The macular ganglion cell complex (mGCC) parameters were significantly reduced in recently diagnosed cases of MS as compared to healthy individuals.
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Affiliation(s)
- Nancy M Lotfy
- Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt; Department of Ophthalmology, Specialised Medical Hospital, Riyadh, Saudi Arabia
| | - Tariq Alasbali
- Imam Mohammed bin Saud Islamic University College of Medicine; Department of Ophthalmology, Specialised Medical Hospital, Riyadh, Saudi Arabia
| | - Rajiv Khandekar
- Department of Research, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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A 30 s test for quantitative assessment of a relative afferent pupillary defect (RAPD): the infrared pupillary asymmetry (IPA). J Neurol 2019; 266:969-974. [PMID: 30746557 DOI: 10.1007/s00415-019-09223-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/30/2019] [Accepted: 01/31/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Detection of a relative afferent pupillary defect (RAPD) by the swinging-light test can be challenging in clinical practice (dark eyes, anisocoria, dark environment). We developed a new method of RAPD quantification based on the recording of the infrared pupillary asymmetry (IPA) with a standard optical coherence tomography (OCT) device. METHODS The diagnostic value of the IPA for detection of the RAPD was determined by receiver-operating characteristic (ROC) curves and area under the curve (AUC). RESULTS Twenty-nine subjects were included in this study (17 controls and 12 unilateral optic neuropathies). The IPA was significantly greater in unilateral optic neuropathies (0.39) compared to controls (0.18, p = 0.001). The diagnostic value was good with a ROC-AUC of 0.843. Importantly, the IPA correlated significantly with the inter-eye percentage difference of the macular ganglion cell-inner plexiform layer (mGCIPL) thickness (R = 0.53, p = 0.01). Assessment of the IPA took less than 30 s. CONCLUSION The present data show that the IPA is a practical and rapid test that can be applied in a clinical setting. The IPA may be a valuable functional outcome measure for clinical trials, complementing structural retinal OCT data in a biological meaningful way. The IPA should be further investigated for suitability for optic neuritis treatment trials.
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Lesiakowski P, Lubiński W, Zwierko T. Evoked potentials in diagnosis of visual dysfunction in amateur boxers. PHYSICIAN SPORTSMED 2018; 46:449-459. [PMID: 29973091 DOI: 10.1080/00913847.2018.1496763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Injuries with varying degrees of temporary or permanent visual dysfunction are common in boxing. This study presents clinical diagnostic information regarding the functional integrity of the visual system in elite amateur boxers. The objective of this study was to assess the presence of normal or abnormal pattern visual evoked potentials (VEP). VEP in boxers were analyzed in relation to the nonathletic group and years of boxing activity. METHODS Clinical examination involved 31 boxers (21 male and 10 female) and 31 controls homogeneous in terms of age and gender. Pattern-reversal VEP elicited by checkerboard stimuli with large (LC) and small checks (SC) under monocular condition were applied. The latency and amplitude of N75, P100 and N135 components of the VEP waveform were analyzed. Absolute values and interocular differences of P100 latency and N75-P100 amplitude were used in determining VEP abnormalities. RESULTS Individual analysis showed prolonged P100 latency in both eyes in one male boxer. Interocular P100 latency differences beyond 8 ms were observed in three male boxers. The N75-P100 amplitude of four boxers exceeded the normal range in both eyes for the LC stimulation and one boxer for the SC stimulation. Interocular N75-P100 amplitude differences beyond the normal range in two cases for both the LC and the SC stimulation were confirmed. There was a positive correlation between years of boxing activity and N75 latency in SC (R = 0.480, p < 0.05) and N75-P100 amplitude in LC (R = -0.370, p < 0.05). CONCLUSION Long-term boxing training may cause impairments in neural conductivity in the visual pathway. VEP seem to be a valuable tool in the neurophysiological diagnosis of visual function in contact sports. They can be recommended as a systematical examination for boxers during training processes for the indication and reduction in the incidence of vision-threatening injuries.
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Affiliation(s)
- Piotr Lesiakowski
- a Department of Physical Education and Sport , Pomeranian Medical University , Szczecin , Poland
| | - Wojciech Lubiński
- b Department of Ophthalmology , Pomeranian Medical University , Szczecin , Poland
| | - Teresa Zwierko
- c Department of Physical Culture and Health Promotion, Laboratory of Kinesiology in Functional and Structural Human Research Center , University of Szczecin , Szczecin , Poland
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Lambe J, Murphy OC, Saidha S. Can Optical Coherence Tomography Be Used to Guide Treatment Decisions in Adult or Pediatric Multiple Sclerosis? Curr Treat Options Neurol 2018; 20:9. [DOI: 10.1007/s11940-018-0493-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Petzold A, Balcer LJ, Calabresi PA, Costello F, Frohman TC, Frohman EM, Martinez-Lapiscina EH, Green AJ, Kardon R, Outteryck O, Paul F, Schippling S, Vermersch P, Villoslada P, Balk LJ. Retinal layer segmentation in multiple sclerosis: a systematic review and meta-analysis. Lancet Neurol 2017; 16:797-812. [PMID: 28920886 DOI: 10.1016/s1474-4422(17)30278-8] [Citation(s) in RCA: 350] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Revised: 03/13/2017] [Accepted: 08/03/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Structural retinal imaging biomarkers are important for early recognition and monitoring of inflammation and neurodegeneration in multiple sclerosis. With the introduction of spectral domain optical coherence tomography (SD-OCT), supervised automated segmentation of individual retinal layers is possible. We aimed to investigate which retinal layers show atrophy associated with neurodegeneration in multiple sclerosis when measured with SD-OCT. METHODS In this systematic review and meta-analysis, we searched for studies in which SD-OCT was used to look at the retina in people with multiple sclerosis with or without optic neuritis in PubMed, Web of Science, and Google Scholar between Nov 22, 1991, and April 19, 2016. Data were taken from cross-sectional cohorts and from one timepoint from longitudinal studies (at least 3 months after onset in studies of optic neuritis). We classified data on eyes into healthy controls, multiple-sclerosis-associated optic neuritis (MSON), and multiple sclerosis without optic neuritis (MSNON). We assessed thickness of the retinal layers and we rated individual layer segmentation performance by random effects meta-analysis for MSON eyes versus control eyes, MSNON eyes versus control eyes, and MSNON eyes versus MSON eyes. We excluded relevant sources of bias by funnel plots. FINDINGS Of 25 497 records identified, 110 articles were eligible and 40 reported data (in total 5776 eyes from patients with multiple sclerosis [1667 MSON eyes and 4109 MSNON eyes] and 1697 eyes from healthy controls) that met published OCT quality control criteria and were suitable for meta-analysis. Compared with control eyes, the peripapillary retinal nerve fibre layer (RNFL) showed thinning in MSON eyes (mean difference -20·10 μm, 95% CI -22·76 to -17·44; p<0·0001) and in MSNON eyes (-7·41 μm, -8·98 to -5·83; p<0·0001). The macula showed RNFL thinning of -6·18 μm (-8·07 to -4·28; p<0·0001) in MSON eyes and -2·15 μm (-3·15 to -1·15; p<0·0001) in MSNON eyes compared with control eyes. Atrophy of the macular ganglion cell layer and inner plexiform layer (GCIPL) was -16·42 μm (-19·23 to -13·60; p<0·0001) for MSON eyes and -6·31 μm (-7·75 to -4·87; p<0·0001) for MSNON eyes compared with control eyes. A small degree of inner nuclear layer (INL) thickening occurred in MSON eyes compared with control eyes (0·77 μm, 0·25 to 1·28; p=0·003). We found no statistical difference in the thickness of the combined outer nuclear layer and outer plexiform layer when we compared MSNON or MSON eyes with control eyes, but we found a small degree of thickening of the combined layer when we compared MSON eyes with MSNON eyes (1·21 μm, 0·24 to 2·19; p=0·01). INTERPRETATION The largest and most robust differences between the eyes of people with multiple sclerosis and control eyes were found in the peripapillary RNFL and macular GCIPL. Inflammatory disease activity might be captured by the INL. Because of the consistency, robustness, and large effect size, we recommend inclusion of the peripapillary RNFL and macular GCIPL for diagnosis, monitoring, and research. FUNDING None.
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Affiliation(s)
- Axel Petzold
- Moorfields Eye Hospital, London, UK; Department of Neurology, Amsterdam Neuroscience, VUmc MS Center Amsterdam and Dutch Expertise Centre for Neuro-ophthalmology, VU University Medical Center, Amsterdam, Netherlands; Institute of Neurology, University College London, London, UK.
| | - Laura J Balcer
- Department of Neurology, Department of Ophthalmology, and Department of Population Health, New York University School of Medicine, New York, NY, USA
| | | | - Fiona Costello
- Department of Clinical Neurosciences and Department of Surgery, University of Calgary, Calgary, AB, Canada
| | - Teresa C Frohman
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Elliot M Frohman
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Elena H Martinez-Lapiscina
- Center of Neuroimmunology, Institute of Biomedical Research August Pi Sunyer, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Ari J Green
- Multiple Sclerosis Center, Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Randy Kardon
- Iowa City VA Center for Prevention and Treatment of Visual Loss, Department of Veterans Affairs Hospital Iowa City, and Department of Ophthalmology and Visual Sciences, University of Iowa Hospital and Clinics, Iowa City, IA, USA
| | - Olivier Outteryck
- Department of Neurology, University of Lille Nord de France, Lille, France
| | - Friedemann Paul
- NeuroCure Clinical Research Center, Charité, Department of Neurology, Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Sven Schippling
- Neuroimmunology and Multiple Sclerosis Research Section, University Hospital Zurich, Zurich, Switzerland
| | - Patrik Vermersch
- Université Lille, CHRU Lille, LYRIC-INSERM U995, FHU Imminent, Lille, France
| | - Pablo Villoslada
- Center of Neuroimmunology, Institute of Biomedical Research August Pi Sunyer, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Lisanne J Balk
- Department of Neurology, Amsterdam Neuroscience, VUmc MS Center Amsterdam and Dutch Expertise Centre for Neuro-ophthalmology, VU University Medical Center, Amsterdam, Netherlands
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15
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Nguyen CTO, Hui F, Charng J, Velaedan S, van Koeverden AK, Lim JKH, He Z, Wong VHY, Vingrys AJ, Bui BV, Ivarsson M. Retinal biomarkers provide "insight" into cortical pharmacology and disease. Pharmacol Ther 2017; 175:151-177. [PMID: 28174096 DOI: 10.1016/j.pharmthera.2017.02.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The retina is an easily accessible out-pouching of the central nervous system (CNS) and thus lends itself to being a biomarker of the brain. More specifically, the presence of neuronal, vascular and blood-neural barrier parallels in the eye and brain coupled with fast and inexpensive methods to quantify retinal changes make ocular biomarkers an attractive option. This includes its utility as a biomarker for a number of cerebrovascular diseases as well as a drug pharmacology and safety biomarker for the CNS. It is a rapidly emerging field, with some areas well established, such as stroke risk and multiple sclerosis, whereas others are still in development (Alzheimer's, Parkinson's, psychological disease and cortical diabetic dysfunction). The current applications and future potential of retinal biomarkers, including potential ways to improve their sensitivity and specificity are discussed. This review summarises the existing literature and provides a perspective on the strength of current retinal biomarkers and their future potential.
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Affiliation(s)
- Christine T O Nguyen
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia.
| | - Flora Hui
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Jason Charng
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Shajan Velaedan
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Anna K van Koeverden
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Jeremiah K H Lim
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Zheng He
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Vickie H Y Wong
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Algis J Vingrys
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Bang V Bui
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Magnus Ivarsson
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
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16
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Leocani L, Rocca MA, Comi G. MRI and neurophysiological measures to predict course, disability and treatment response in multiple sclerosis. Curr Opin Neurol 2016; 29:243-53. [DOI: 10.1097/wco.0000000000000333] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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17
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Laible M, Jarius S, Mackensen F, Schmidt-Bacher A, Platten M, Haas J, Albrecht P, Wildemann B. Adding Papillomacular Bundle Measurements to Standard Optical Coherence Tomography Does Not Increase Sensitivity to Detect Prior Optic Neuritis in Patients with Multiple Sclerosis. PLoS One 2016; 11:e0155322. [PMID: 27171375 PMCID: PMC4865166 DOI: 10.1371/journal.pone.0155322] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 04/27/2016] [Indexed: 11/27/2022] Open
Abstract
Purpose To improve the detection of retinal nerve fiber layer (RNFL) thinning in multiple sclerosis (MS), a special peripapillary ring scanning algorithm (N-site RNFL, N-RNFL) was developed for spectral domain optical coherence tomography (SD-OCT). In contrast to the standard protocol (ST-RNFL) scanning starts nasally, not temporally, and provides an additional sector of analysis, the papillomacular bundle (PMB). We aimed to ascertain whether the temporal RNFL differs between the two techniques, whether N-RNFL is more sensitive than ST-RNFL to detect previous optic neuritis (ON), and whether analyzing the PMB adds additional sensitivity. Furthermore, we investigated whether RNFL is associated with disease severity and/or disease duration. Methods We conducted a cross-sectional case-control study of 38 patients with MS, of whom 24 had a history of ON, and 40 healthy controls (HC). Subjects with ON within the previous 6 months were excluded. Records included clinical characteristics, visual evoked potentials (VEP), and SD-OCT in both techniques. Results In a total of 73 evaluable MS eyes, temporal N-RNFL was abnormal in 17.8%, temporal ST-RNFL in 19.2%, and the PMB-RNFL in 21.9%. In ON eyes, the sensitivity of temporal N-RNFL and ST-RNFL did not differ significantly (37.0%/33.3%, p = 0.556). The sensitivity of VEP was 85.2%. RNFL thickness was associated with disease severity in all eyes, with and without a history of ON, and with disease duration. Conclusion The two OCT techniques detected previous ON with similar sensitivity, but the sensitivity of VEPs was superior to that of both N-RNFL and ST-RNFL. Our results indicate that the widely used ST-RNFL technique is appropriate for peripapillary RNFL measurements in MS patients.
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Affiliation(s)
- Mona Laible
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Sven Jarius
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Annette Schmidt-Bacher
- Department of Ophthalmology, Heidelberg University Hospital, Heidelberg, Germany
- Department of Ophthalmology, St. Vincentius-Kliniken gAG, Karlsruhe, Germany
| | - Michael Platten
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Jürgen Haas
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Philipp Albrecht
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Germany
| | - Brigitte Wildemann
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
- * E-mail:
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