Comparison of retinal nerve fibre layer thickness with visual evoked potential and visual field in patients with multiple sclerosis

Abstract

Background: To evaluate retinal nerve fibre layer thickness and to compare results with visual evoked potentials and visual field in patients with multiple sclerosis. Design: A prospective, case-control study, university hospital setting. Participants: Seventy-three eyes of 37 multiple sclerosis patients and 74 eyes of 37 healthy subjects. Methods: All patients underwent a complete neurological and ophthalmological examination and peripapillary retinal nerve fibre layer thickness was evaluated using scanning laser polarimetry (GDx). Furthermore, visual evoked potential and visual field testing were performed. Main Outcome Measures: The chi(2) test, Student's t-test, Mann-Whitney U-test and Pearson's correlation coefficient analysis of the GDx, visual evoked potential and visual field testing parameters. Results: GDx measurements showed significantly more retinal nerve fibre layer damage in the patients than in the control groups. Comparison of the GDx parameters between patients with optic neuritis and non-optic neuritis demonstrated a statistically significant difference in symmetry (P = 0.046) and superior/nasal parameters (P = 0.009). A correlation was found between the number, superior and inferior ratio parameters, and P100 amplitude obtained with visual evoked potential in patients with non-optic neuritis. Additionally, there was a correlation between the number, inferior ratio and superior/nasal parameters, and the mean deviation of visual field in the non-optic neuritis group. Conclusions: For retinal nerve fibre layer thickness measurements in multiple sclerosis patients, the GDx, along with other techniques, such as visual evoked potential, can be used as a diagnostic and follow-up criterion, particularly in patients without optic neuritis.