Optic Nerve Topography in Multiple Sclerosis Diagnosis: The Utility of Visual Evoked Potentials

Angela Vidal-Jordana*, Alex Rovira, Georgina Arrambide, Susana Otero-Romero, Jordi Río, Manuel Comabella, Carlos Nos, Joaquin Castilló, Ingrid Galan, Sergio Cabello, Dulce Moncho, Kimia Rahnama, Vanessa Thonon, Breogan Rodríguez-Acevedo, Ana Zabalza, Luciana Midaglia, Cristina Auger, Jaume Sastre-Garriga, Xavier Montalban, Mar Tintoré

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

14 Citations (Scopus)


ObjectiveTo assess the added value of the optic nerve region (by using visual evoked potentials [VEPs]) to the current diagnostic criteria.MethodsFrom the Barcelona clinically isolated syndrome (CIS) cohort, patients with complete information to assess dissemination in space (DIS), the optic nerve region, and dissemination in time at baseline (n = 388) were selected. Modified DIS (modDIS) criteria were constructed by adding the optic nerve to the current DIS regions. The DIS and modDIS criteria were evaluated with univariable Cox proportional hazard regression analyses with the time to the second attack as the outcome. A subset of these patients who had at least 10 years of follow-up or a second attack occurring within 10 years (n = 151) were selected to assess the diagnostic performance. The analyses were also performed according to CIS topography (optic neuritis vs non-optic neuritis).ResultsThe addition of the optic nerve as a fifth region improved the diagnostic performance by slightly increasing the accuracy (2017 DIS 75.5%, modDIS 78.1%) and the sensitivity (2017 DIS 79.2%, modDIS 82.3%) without lowering the specificity (2017 DIS 52.4%, modDIS 52.4%). When the analysis was conducted according to CIS topography, the modDIS criteria performed similarly in both optic neuritis and non-optic neuritis CIS.ConclusionThe addition of the optic nerve, assessed by VEP, as a fifth region in the current DIS criteria slightly improves the diagnostic performance because it increases sensitivity without losing specificity.

Original languageEnglish
Pages (from-to)E482-E490
Number of pages9
Issue number4
Publication statusPublished - 26 Jan 2021


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