Evaluation of the diagnostic and differential diagnostic value of SOCT and microperimetry methods in patients with visual disturbances due to multiple sclerosis

Purpose: statistical evaluation of the diagnostic and differential diagnostic significance of spectral optical coherent tomography (SOCT) and microperimetry methods in patients with (1) optic neuritis (ON) with multiple sclerosis (MS) manifestation; (2) inflammation-related ON and (3) optic nerve atrophy (ONA) caused by MS.

Materials  and methods. The results of examination  of the three groups of patients were processed by correlation and multivariate  analysis and binary logistic regression. The threshold of electrical sensitivity (EST) and electrical lability (EL) were determined on a Fosphen-tester using a standard technique. S-OCT was performed on Cirrus HD-OCT (Carl Zeiss Meditec Inc.,  USA) using the RNFL Thickness  Analysis, Ganglion Cell Analysis programs. Computer microperimetry was done on MP-1 (Nidek technologies, Vigonza, Italy)  using the macula 12º 10 dB program.

Results. EST  of the retina was found to have a strong bilateral correlation with the average retinal sensitivity, RNFL thickness and thickness of the upper temporal and upper segments layer of the complex GCL + IPL. Diagnostic parameters significant for visual analyzer disorders caused by MS were revealed and confirmed, including the average retinal sensitivity drop within 6º from the center of the visual field according to microperimetry (p < 0.0005), the thinning of RNFL (p < 0.005) and complex GCL-S + IPL, according to SOCT (p = 0.004). intragroup comparisons revealed the diagnostic significance of SOCT in early diagnosis of ONA due to MS (p < 0.0005).  It was found that if the RNFL was 62 microns or less, the GCL-S + IPL  was 52 microns or less (in the inferior segment it was 50 microns or less, and in the upper segment it was 51 microns or less) then, with a sensitivity of 100 % and a specificity of 87.5–93 %, it is an evidence of the atrophy of the optic nerve.

Conclusion: average retinal photosensitivity within 6º from the center of the visual field, RNFL thickness,  thickness GCL-S + IPL, including that in the superior, superior temporal and inferior segments can be considered as diagnostically significant values in OH inflammatory-related and demyelinating OH and the development of ONA due to MS.

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