Evaluatıon of pattern vep and vısual fıeld fındıngs ın multıple sclerosıs patıents wıth complete vısual acuıty

Objective: In this study, MS patients with complete visual acuity, who had no visual symptoms, were evaluated via pattern VEP and thirty central degrees of visual field.Material and Method: A total 120 eyes, consisting of 60 eyes of 30 patients in follow-up at Neurology clinics with MS diagnosis, who had complete visual acuity and no visual symptoms and 60 eyes of 30 healthy subjects who had no other disease with the exception of refractive defects during policlinic examination were included in the study.The 30 MS patients (8 males, 22 females) included in the study were divided into 3 groups;Group 1 (optic neuritis (+) group): Patients with complaints of temporarily decreased sight and blurry vision were included in the optic neuritis (+) group.Group 2 (optic neuritis (?) group): Patients who had no visual complaints were included in the optic neuritis (-) groupGroup 3 (optic neuritis (+) group + optic neuritis (?) group): All MS patients included in the study, regardless of whether they had previous visual complaints, were included in this group.Prospectively, SITA FAST central 30-2 threshold visual field tests with white-on-white perimetry and 1 degree (60 minutes) ? 0.3 degrees (18 minutes) pattern VEP measurements were performed on patients.Results: Mean age in Group 1 (5 males, 12 females), Group 2 (3 males, 9 females), Groups 3 (8 males, 22 females) and control group (12 males, 18 females) included in the study were 37.00±6.82, 33.66±8.92, 34.73±11.13 ve 35.66± 7.83, respectively, and there was no significant difference among the 4 groups (p>0.005). MD, PSD, p100 latency (msn) 1?- 0.3?, p100 amplitude (µV) 1?-0,3? values and central 0-30, 10-20, 10-30, 20-30 degrees of retinal sensitivity (db) showed significant difference (p<0.005) between Group 3 and the control group, however, there was no significant diffence between the groups regarding central 0-10, 0-20 degrees (p>0.005). MD, PSD, p100 latency (msn) 1?- 0.3?, and central 0-30, 10-30, 20-30, degrees of retinal sensitivity (db) showed significant difference (p<0.005) between Group 2 and the control group, however, there was no significant diffence between the groups regarding p100 amplitude (µV) 1?-0,3, central 0-10, 0-20, 10-20 degrees (p>0.005). MD, PSD, p100 latency (msn) 1?, p100 amplitude (µV) and central 0-20, 0-30, 10-20, 10-30, 20-30 degrees of retinal sensitivity (db) showed significant difference (p<0.005) between Group 1 and the control group, however, there was no significant diffence between the groups regarding p100 latency (msn) 0.3?, central 0-10 degrees (p>0.005). MD, PSD, p100 latency (msn) 1?-0,3?, p100 amplitude (µV) 0,3? and central 0-10, 0-20, 0-30, 10-20, 10-30, 20-30 degrees of retinal sensitivity (db) showed significant difference (p<0.005) between Group 1 and Group 2.Conclusion: The results demonstrate visual field impairment and prolonged P100 latency in MS patients with complete sight, regardless of optic neuritis history, indicating that present alterations can not be associated with the episode in patients with a history of optic neuritis episode and some alterations develop through the chronic course of the disease. The VEP amplitudes are significantly decreased in two different spatial frequencies compared to the control population. In the light of this observation, we conclude that the clinical parameters may not reflect the underlying pathologic process threatening axonal integrity due to the axon loss compensation ability of the visual system. Therefore, pattern VEP may serve as an objecitve tool to assist diagnosis and follow-up of axonal pathology in MS.Key words: multiple sclerosis, visually evoked potentials, axonal damage, VEP amplitudes, latency, neurodegeneration, neuroregeneration, visual field alterations, retinal sensitivity