ABSTRACT
BACKGROUND: Contrast acuity (identification of low-contrast letters on a white background) is frequently reduced in patients with demyelinating optic neuropathy associated with multiple sclerosis (MS), even when high-contrast (Snellen) visual acuity is normal. Since visual evoked potentials (VEPs) induced with high-contrast pattern-reversal stimuli are typically increased in latency in demyelinating optic neuropathy, we asked if VEPs induced with low-contrast stimuli would be more prolonged and thus helpful in identifying demyelinating optic neuropathy in MS. METHODS: We studied 15 patients with clinically definite MS and 15 age-matched normal controls. All subjects underwent a neuro-ophthalmologic assessment, including measurement of high-contrast visual acuity and low-contrast acuities with 25%, 10%, 5%, 2.5%, and 1.25% contrast Sloan charts. In patients with MS, peripapillary retinal nerve fiber layer (RNFL) thickness was determined using optical coherence tomography. Monocular VEPs were induced using pattern-reversal checkerboard stimuli with 100% and 10% contrast between checks, at 5 spatial frequencies (8-130 minutes of arc). RESULTS: VEP latencies were significantly increased in response to low- compared with high-contrast stimuli in both groups. VEP latencies were significantly greater in patients with MS than controls for both high- and low-contrast stimuli. VEP latencies correlated with high- and low-contrast visual acuities and RNFL thickness. VEPs were less likely to be induced with low- than with high-contrast stimuli in eyes with severe residual visual loss. CONCLUSIONS: Visual evoked potentials obtained in patients with multiple sclerosis using low-contrast stimuli are increased in latency or absent when compared with those obtained using high-contrast stimuli and, thus, may prove to be helpful in identifying demyelinating optic neuropathy.
Subject(s)
Contrast Sensitivity/physiology , Evoked Potentials, Visual/physiology , Optic Nerve Diseases/diagnosis , Optic Nerve Diseases/etiology , Reaction Time/physiology , Adult , Aged , Case-Control Studies , Electroencephalography/methods , Female , Humans , Male , Middle Aged , Multiple Sclerosis/complications , Photic Stimulation/methods , Statistics as Topic , Tomography, Optical Coherence/methods , Visual Acuity/physiologySubject(s)
Charities/economics , Financial Management/standards , Organizations, Nonprofit/economics , Administrative Personnel/standards , Charities/organization & administration , Charities/standards , Ethics, Institutional , Financial Management/methods , Organizations, Nonprofit/standards , United StatesABSTRACT
The gastric and duodenal ulcers in the elderly have an ever increasing incidence. The active follow-up, the dietary and drug treatment determine a decreased number of surgical interventions.
