ABSTRACT
We studied 20 patients with acute optic neuritis prospectively for 12 months. Visual fields, color vision, and VEPs to 15' checks were initially abnormal in all patients. Visual acuity was abnormal in 90% and contrast sensitivity in 95% of patients. We devised a graded visual impairment scale (GVIS) to include all visual functions tested. Complete recovery of visual function occurred in 65% of cases. Recovery in the majority of patients was rapid and complete within the first 2 months. In some patients, improvement continued over 6 months. The initial classification on the GVIS was significantly correlated with the final outcome. Patients initially classified as having moderate visual impairment recovered completely or improved to near normal vision. Sixty percent of patients initially classified as total or severe blindness had permanent visual impairment. VEP latency remained prolonged in 19 patients, even when their vision had returned to normal, and is a reliable indicator of resolved optic neuritis.
Subject(s)
Optic Neuritis/physiopathology , Adult , Evoked Potentials, Visual , Female , Humans , Male , Middle Aged , Optic Neuritis/complications , Prognosis , Prospective Studies , Vision Disorders/etiology , Vision Disorders/physiopathology , Vision Tests , Vision, Monocular , Visual AcuityABSTRACT
This study compared visual evoked potentials (VEP) and contrast sensitivity (CS) as methods of detecting visual loss in 15 women with acute onset of pseudotumor cerebri (PTC). A total of 24 out of 30 eyes (14 of 15 patients) had a visual disturbance. Neuro-ophthalmologic examination demonstrated abnormal Goldmann visual fields in 13 of 30 eyes. CS was abnormal in 18 eyes; VEP was abnormal in five eyes. Nine eyes had visual loss detected by CS only, five by perimetry only, and one had the VEP as the sole abnormality. CS was a valuable adjunct to perimetry in PTC whereas VEP was rarely helpful.
