Optic Nerve in Multiple Sclerosis Diagnostic Criteria
| Autor: | Steven Galetta, Wallace J Brownlee |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Multiple Sclerosis Optic Neuritis genetic structures Eye Article 03 medical and health sciences 0302 clinical medicine medicine Humans In patient 030212 general & internal medicine business.industry Multiple sclerosis Optic Nerve medicine.disease Spinal cord medicine.anatomical_structure Optic nerve Evoked Potentials Visual Dissemination in space Neurology (clinical) Brainstem Radiology business 030217 neurology & neurosurgery |
| Zdroj: | Neurology article-version (Version of Record) 3 |
| ISSN: | 1526-632X 0028-3878 |
| DOI: | 10.1212/wnl.0000000000011344 |
| Popis: | Objective To assess the added value of the optic nerve region (by using visual evoked potentials [VEPs]) to the current diagnostic criteria. Methods From 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). Results The 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. Conclusion The 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. |
| Databáze: | OpenAIRE |
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