#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

The Examination of Visual Evoked Potentials and Ultrasound Evaluation of Orbital Hemodynamics in Acute Unilateral Optic Neuritis – Significance for Clinical Practice


Authors: P. Hradílek;  F. Vlček;  O. Zapletalová;  D. Školoudík
Authors‘ workplace: Neurologická klinika FNsP Ostrava-Poruba
Published in: Cesk Slov Neurol N 2007; 70/103(1): 78-83
Category: Short Communication

Overview

Unilateral optic neuritis (ON) is a common first manifestation of multiple sclerosis, however, it can occur during the disease course as well. In addition to the evaluation of clinical signs and ophthalmologic examination, visual evoked potentials (VEP) are the main method to support the diagnosis of ON. Further methods could also contribute to the determination of this diagnosis.

Our objective was to compare the results of VEP examination and ultrasound evaluation of orbital hemodynamics in subjects with acute unilateral ON.

A group of 24 consecutive patients with acute unilateral ON had undergone VEP examination and ultrasound evaluation of blood-flow parameters and peripheral resistance in the ophthalmic circulation before the therapy with steroids was initiated.

Pathological VEPs were found in 18 patients on the clinically impaired eye, and pathological parameters of orbital hemodynamics were revealed in 21 patients on the clinically impaired eye.

Due to high prevalence of abnormal findings the ultrasound evaluation of orbital hemodynamics is considered sensitive and helpful for determining the diagnosis of acute unilateral ON, especially in cases with non-conclusive VEP results.

Key words:
optic neuritis, visual evoked potentials, ultrasound, orbital hemodynamics


Sources

1. Bednařík J, Kadaňka Z, Polčáková M, Dufek J, Patočková L. Samostatná optická neuritida – krátkodobé riziko rozvoje sclerosis multiplex a možnost jeho predikce pomocí multimodálních imunoglobulinů v likvoru. Choroby hlavy a krku 1992; 2: 26-9.

2. Kraus H (Ed). Kompendium očního lékařství. Praha: Grada Publishing 1997.

3. Fazzone HE, Lefton DR, Kupersmith MJ. Optic neuritis. Correlation of pain and magnetic resonance imaging. Ophthalmology 2003; 110: 1646-9.

4. Chan JW. Optic neuritis in multiple sclerosis. Ocular Immunology and Inflammation 2002; 10: 161-86.

5. Otradovec J. Klinická neurooftalmologie. Praha: Grada Publishing; 2003.

6. Compston A, Ebers G, Lassmann H, McDonald J, Matthews PM, Wekerle H. McAlpine´s Multiple Sclerosis. 3rd ed. London: Churchill Livingstone 1998.

7. Frederiksen JL, Petera J. Serial visual evoked potentials in 90 untreated patients with acute optic neuritis. Surv Ophthalmol 1999; 44(Suppl 1): S54-S62.

8. Školoudík D, Brozman M. Základy ultrazvukového vyšetření a hemodynamiky. In: Školoudík D, Škoda O, Bar M, Brozman M, Václavík D (Eds). Neurosonologie. Praha: Galén 2003: 1-26.

9. Hradílek P. Nálezy u neuritidy n. optici. In: Školoudík D, Škoda O, Bar M, Brozman M, Václavík D (Eds). Neurosonologie. Praha: Galén 2003: 138-40.

10. Hradílek P, Zapletalová O, Doležil D, Školoudík D. Acute Optic Neuritis in Multiple Sclerosis. Evaluation of Hemodynamics in the Ophthalmic Artery with Colour Doppler Imaging. Neuro-Ophthalmol 2005; 29: 161-4.

11. Elvin A, Andersson T, Soderstrom M. Optic Neuritis: Doppler ultrasonography compared with MR and correlated visual evoked potential assessments. Acta Radiol 1998; 39: 243-8.

12. Akarsu C, Tan FU, Kendi T. Color Doppler Imaging in optic neuritis with multiple sclerosis. Graefe´s Arch clin Exp Ophthalmol 2004; 242(12): 990-4.

13. Karaali K, Senol U, Aydin H, Cevikol C, Apaydin A, Lüleci E. Optic neuritis: evaluation with orbital Doppler Sonography. Radiology 2003; 226: 355-8.

14. McDonald WI, Compston A, Edan G, Goodkin D, Hartung HP, Lublin FD et al. Recommended diagnostic criteria for MS: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol 2001; 50: 121-7.

15. Stejskal L (Ed). Evokované odpovědi a jejich klinické využití. Praha: Praha Publishing 1993.

16. Jones SJ. Visual evoked potentials after optic neuritis. Efect of time interval age and disease dissemination. J Neurol 1993; 240: 489-94.

17. Speciale L, Sarasella M, Ruzzante S. Endothelin and nitric oxid levels in cerebrospinal fluid of patients with multiple sclerosis. J Neurovirol 2000; Suppl 2: 62-6.

18. Pache M, Kaiser HJ, Akhalbedashvili N. Extraocular blood flow and endothelin-1 plasma levels in patients with multiple sclerosis. Eur Neurol 2003;

49: 164-168.

19. Gerling J, Janknecht P, Nansen LL. Diameter of the optic nerve in idiopathic optic neuritis and in anterior ischemic optic neuropathy. Int Ophthalmol 1997; 21: 131-5.

20. Karadeniz-Bilgili MY, Ekmekci Y, Koksal A, Akarsu C, Ziraman I. Effects of Hypertension and Antihypertensive Treatment on Retrobulbar Circulation Detected on Doppler Sonography. J Ultrasound Med 2004; 23: 13-7.

21. Williamson TH, O´Lowe GD, Barter GM. Influence of age, systemic blood pressure, smoking, and blood viscosity on orbital blood velocities. Br J Ophthalmol 1995; 79: 17-22.

22. Frederiksen JL, Petera J. Serial visual evoked potentials in 90 untreated patients with acute optic neuritis. Surv Ophthalmol 1999-44(Suppl 1): S54-S62.

Labels
Paediatric neurology Neurosurgery Neurology

Article was published in

Czech and Slovak Neurology and Neurosurgery

Issue 1

2007 Issue 1

Most read in this issue
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#