Combining Optical Coeherence Tomography, Full-Field and Multifocal Visual Evoked Potentials to Assess Multiple Sclerosis Patients

Objective: to explore whether a multimodal visual system evaluation, comprehensive of optical coherence tomography (OCT), full-field visual evoked potentials (ff-VEPs) and multifocal visual evoked potentials (mf-VEPs), could be useful to assess MS patients in everyday clinical practice. Background: in MS research OCT is used to measure RNFL thickness as a marker of axonal loss, while VEPs as an indicator of demyelination. However still little is known about the utility of OCT, ff-VEPs and mf-VEPs combined use in routine neurological clinical practice. Design/Methods: cross-sectional observational study. 150 MS patients (11 CIS, 89 RRMS, 33 SPMS, 17 PPMS, mean age 40±11.75 years, mean disease duration 8.48±8.06 years, median EDSS 2.0 - range 0.0-7.5) underwent neurological and neurophysiological evaluation with OCT, ff-VEPs and mf-VEPs. Results: considering eyes without previous optic neuritis (ON) OCT, ff-VEPs and mf-VEPs combination was significantly more sensitive than each technique considered separately (70.2[percnt] vs 32.8[percnt], 55.6[percnt] and 53.0[percnt] respectively, McNemar pu0026lt:0.001). OCT, ff-VEPs and mf-VEPs together were also superior to OCT associated with another single functional technique (70.2[percnt] vs 61.1[percnt] for OCT plus ff-VEP and 59.1[percnt] for OCT plus mf-VEPs, McNemar pu0026lt:0.001). Sensitivity increase due to techniques’ combination was less remarkable when considering eyes with previous ON (u0026gt:3 months): the three techniques together were not superior to OCT associated with ff-VEPs or mf-VEPs (85.2[percnt] vs 81.5[percnt], McNemar p=0.250 and 85.2[percnt] vs 80.2[percnt], McNemar p=0.125 respectively). Finally, in the acute phase of ON (u0026lt:3 months), ff-VEPs and mf-VEPs alone showed good diagnostic power (90.5[percnt] vs 71.4[percnt], McNemar p=0.125), with no sensitivity increase when combined with OCT use. Conclusions: these results may suggest the usefulness of a routine multimodal approach (combining morphological and functional informations) to the visual system in MS, especially when examining asymptomatic eyes. Disclosure: Dr. Guerrieri has nothing to disclose. Dr. Di Maggio has nothing to disclose. Dr. Pisa has nothing to disclose. Dr. Vitali has nothing to disclose. Dr. Santangelo has nothing to disclose. Dr. Medaglini has nothing to disclose. Dr. Moiola has received personal compensation for activities with Biogen Idec, Genzyme-Sanofi, Novartis and Merck Serono as a speaker, Dr. Del Carro has nothing to disclose. Dr. Martinelli has received personal compensation for activities with Biogen Idec, Merck Serono, Bayer Schering Pharma, Teva Pharmaceutical Industries Ltd., and sanofi-aventi. Dr. Comi has received personal compensation for activities with Teva, Novartis, Genzyme, Merck Serono, Biogen, Bayer, Actelion, Almirall, and Serono Symposia International Foundation. Dr. Leocani has received personal compensation for activities with AbbVie, Almirall, Biogen, Excemed, Genzyme, EMD Serono, and Novartis.