Optical coherence tomography and visual evoked potentials: which is more sensitive in multiple sclerosis?

Mult Scler. 2014 Sep;20(10):1342-7. doi: 10.1177/1352458514524293. Epub 2014 Mar 3.


Objective: To assess the sensitivity of optic coherence tomography (OCT) and visual evoked potentials (VEPs) to visual pathway abnormalities in multiple sclerosis (MS).

Methods: A total of 40 MS subjects, 28 with optic neuritis (ON) at least 3 months before (bilateral in 5), underwent assessment of visual acuity, Expanded Disability Status Scale (EDSS), OCT and VEPs, the latter quantified with a 0-4 conventional score.

Results: OCT and VEPs were abnormal in 36% and 56% respectively in all eyes (p=0.11), 68% and 86% in eyes with previous ON (p=0.12), and in 19% versus 40% in eyes without ON history (p=0.007). Combining VEP and OCT increased sensitivity to 89% in ON and 44% in non-ON eyes. Considering all eyes, global retinal nerve fibre layer (RNFL) thickness and VEP score were significantly correlated between them (ρ=-0.63, p<0.001) and with EDSS (RNFL: ρ=0.40, p<0.001; VEP score: ρ=0.47, p<0.001). Disease duration correlated with VEP score (ρ=0.25, p=0.025) and RNFL thickness (ρ=-0.71, p<0.001).

Conclusions: In eyes without ON, VEPs were more frequently abnormal than OCT, while the two techniques showed similar sensitivity in eyes previously affected by ON. The correlation of VEPs and OCT measures with disability prompts further exploration of the two techniques as potential markers of disease burden.

Keywords: Multiple sclerosis; disability; optic coherence tomography; optic neuritis; spectral domain; visual evoked potentials.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Disability Evaluation
  • Electroencephalography*
  • Evoked Potentials, Visual*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis / diagnosis*
  • Multiple Sclerosis / pathology
  • Multiple Sclerosis / physiopathology
  • Optic Nerve / pathology*
  • Optic Nerve / physiopathology*
  • Optic Neuritis / diagnosis*
  • Optic Neuritis / pathology
  • Optic Neuritis / physiopathology
  • Photic Stimulation
  • Predictive Value of Tests
  • Prognosis
  • Reaction Time
  • Retinal Neurons / pathology*
  • Severity of Illness Index
  • Time Factors
  • Tomography, Optical Coherence*
  • Visual Acuity